Can Serum Amylase Level Evaluation Facilitate Early Diagnosis of Acute Appendicitis, as an adjunctive biomarker?

Abstract

Introduction: Acute Appendicitis is considered as a medical emergency, one of the most prevalent etiologies for acute abdominal pain. Perforated cases of acute appendicitis are possible sequences of late diagnosis. One of the biomarkers that can be a potential target in diagnosis of acute appendicitis is serum amylase level evaluation which this study is focused on. Material and Method: 627 patients with acute abdominal pain included in the trial. 125 cases out of these 627,18-65 years old patients with acute abdominal pain whom were suspected of appendicitis were undergone appendectomy surgery due to clinical and paraclinical scoring during standard treatment. At arrival serum amylase evaluation was done for all participants. Macroscopic reports of surgery and histopathologic reports have been recorded. Amylase serum level and its correlation with the acute appendicitis diagnosis and their complications were analyzed with the use of variance test, chi-square tests, ROC curve. Results: Findings showed, in patients with normal appendix, serum amylase level mean was 55.40mg/dl, and in patient with simple acute appendicitis was 33.32mg/dl, and in complicated appendicitis was 62.40mg/dl which had statistically significant differences (P-value=0.003). Data also showed serum amylase level in the diagnosis of complicated appendicitis in the cutting point 34.5, had Sensitivity , specificity,positive predictive value,negative predictive value 100%, 56%, 64.5% and 100%, and the total accuracy of the test is 75.5%. Conclusion: Serum amylase level can be used in more precise diagnosis of acute appendicitis, complicated appendicitis as an adjunctive biomarker. possibly it can help that acute appendicitis and its complication get early diagnosis.