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


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


  1. Busireddy KK., et al. “Pancreatitis imaging approach”. World Journal of Gastrointestinal Pathophysiology3 (2014): 252-270.
  2. Williford ME., et al. “Pancreatic pseudocyst: comparative evaluation by sonography and computed tomography”. American Journal of Roentgenology1 (1983): 53-57.
  3. Lin A and Feller ER. “Pancreatic carcinoma as a cause of unexplained pancreatitis: Report of ten cases”. Annals of Internal Medicine 2 (1990): 166-167.
  4. Banks PA and Freeman ML. “Practice guidelines in acute pancreatitis”. American Journal of Gastroenterology 10 (2006): 2379- 400.
  5. Isenmann R., et al. “Pancreatic necrosis: an early Finding in severe acute pancreatitis”. Pancreas3 (1993): 358-361.
  6. Paspulati RM. “Multidetector CT of pancreas”. Radiology Clinics of North America6 (2005): 999-1020.
  7. Sambasivarao K., et al. “Role of Ct in the Evaluation of Acute Pancreatitis”. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS)1 (2020): 69-73.
  8. Gonapati S., et al. “Role of CECT in acute pancreatitis and correlation of MCTSI with clinical outcome”. International Journal of Contemporary Medicine, Surgery and Radiology 2 (2019): B11-B15.
  9. Kiranmai R and Naidu YT. “A study on significance of computed tomographic evaluation of acute pancreatitis: A prospective observational study”.
  10. Lankisch PG., et al. “Acute pancreatitis: does gender matter?”. Digestive Diseases and Sciences11 (2001): 2470-2474.
  11. Sharma RG., et al. “Evaluation of Serum Amylase and Lipase in 100 Cases of Acute Abdomen”.
  12. Gwozdz GP., et al. “Comparative evaluation of the diagnosis of acute pancreatitis based on serum and urine enzyme assays”. Clinica Chimica Acta3 (1990): 243-254.
  13. Sharif MM., et al. “Relation of Pancreatic Enzymes and Serum Transaminases Levels with Modified CT Severity Index in Acute Pancreatitis”. BIRDEM Medical Journal3 (2015): 18-24.
  14. Sutton PA., et al. “The role of routine assays of serum amylase and lipase for the diagnosis of acute abdominal pain”. The Annals of the Royal College of Surgeons of England5 (2009): 381-384.
  15. Amogh VN., et al. “Prospective Evaluation of Acute Pancreatitis in Early Diagnosis Using Modified CT Severity Index”. International Journal of Anatomy, Radiology and Surgery 3 (2018): RO07-RO11.
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.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

December Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the November issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

ECronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before December 23, 2022.

Certificate of Publication

ECronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

ECronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.