Research Article
Volume 9 Issue 4 - 2022
To Assess the Severity of Acute Pancreatitis by Correlating the Levels of Serum Amylase and Lipase with Modified CT Severity Index
Jatin Bedi1*, Ram Gopal Sharma2, Nischal S1 and Shabool Nafees1
1Resident, Department of General Surgery, MMIMSR, MMDU, Mullana, Ambala, Haryana, India
2Professor, Department of General Surgery, MMIMSR, MMDU, Mullana, Ambala, Haryana, India
*Corresponding Author: Jatin Bedi, Resident, Department of General Surgery, MMIMSR, MMDU, Mullana, Ambala, Haryana, India.
Received: January 07, 2022; Published: March 30, 2022




Abstract

Background: Contrast enhanced CT is the investigation of choice for diagnosing acute pancreatitis. It also helps in assessing the severity of acute pancreatitis and is usually done after 72 hours of symptoms of the disease.

Objectives: 1. To correlate the levels of serum amylase and lipase with modified CT severity index in acute pancreatitis. 2. To assess the severity of acute pancreatitis by comparing levels of serum amylase and lipase with modified CT severity index.

Material and Methods: This prospective study was conducted on 50 patients with acute pancreatitis admitted to the surgical wards of M.M.I.M.S.R, Mullana during a period of October 2019 to September 2021. All the patients meeting the inclusion criteria were taken in this study. In these patients, the blood samples were taken before starting any treatment and estimation of serum amylase and lipase was performed within twenty-four hours, and on fifth and tenth day and CECT whole abdomen was done on 3rd day of admission and patients were graded according to the modified CT severity index according to CT findings.

Results: In this study of 50 patients, males were 33 and females were 17. Among these 32% patients were having edematous pancreatitis and 26% had pancreatic necrosis. Other CT findings like focal/diffuse pancreatic enlargement, peri-pancreatic fat stranding and peri-pancreatic fluid collection were present in 72%, 66% and 36% of the patients respectively. In our study most common etiology of acute pancreatitis was alcohol (70%). The diagnostic sensitivity of serum amylase and serum lipase acute pancreatitis were 44% and 72% respectively with CT showing 100% accuracy and sensitivity. In our study according to modified CT severity index majority were mild (58%) while rest were moderate (26%) and severe (16%).

Conclusion: Serial evaluation of biochemical markers (amylase and lipase) was done in acute pancreatitis patients for ten days showed that rise in lipase levels persisted longer than those of amylase. Serum lipase concentration ≥ 3 times the upper limit of the laboratory reference range is highly sensitive for diagnosing acute pancreatitis and corresponding value for amylase is moderately sensitive for the same. Computed tomography is the most sensitive and non-invasive imaging helps to differentiate the type of acute pancreatitis (edematous and necrotizing) which is not possible with serum lipase and amylase levels. The modified CT severity index aids in determining the extent of pancreatic necrosis and predicting the likelihood of local and systemic consequences. MCTSI grading (mild and moderate) correlated well with the serum amylase levels.

Keywords: Computed Tomography; Acute Pancreatitis; Modified CT Severity Index; Pancreatic Necrosis; Sensitivity

References

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Citation: Jatin Bedi., et al. “To Assess the Severity of Acute Pancreatitis by Correlating the Levels of Serum Amylase and Lipase with Modified CT Severity Index”. EC Gastroenterology and Digestive System 9.4 (2022): 92-105.

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