Prevalence, causes, and outcome of non-diagnostic amylase in acute pancreatitis: A single institution experience

Abstract

Objectives: To determine the prevalence, common causes, and outcome of non diagnostic amylase in acute pancreatitis. Materials and Methods: The data of 81 patients was looked at retrospectively. This was extracted from the patient's records with the diagnosis of acute pancreatitis from June 2010 to June 2012. These patients were admitted to King Abdulaziz University Hospital. The data included demographics, amylase level, causes and outcome. Two groups were devised group 1, non diagnostic amylase, and group 2, diagnostic amylase. Results: Out of 81 patients, 33(41%) were males, and 48(59%) were females. Age ranging from 24-75 years with a mean age of 49. Only 10(12%) of the patients were found to have amylase that is not raised up to the diagnostic level. Gallstones were the commonest cause in both groups, while hyperlipidemia was higher in group 1(20%), than group 2(8.5%). Idiopathic in 40% and 14% in group 1 and 2 respectively. Post ERCP acute pancreatitis was only seen in group 2(8.5%). The outcome was indicated by; pseudocyst which was not present in both groups, necrosis which was only present in group 2 in 4%, Intensive care unit (ICU) admission was seen in 20% of group 1 patients due to delay in diagnosis, and in 4% of group 2 due to necrosis, and mortality was absent in both groups. Conclusion: Prevalence of acute pancreatitis in non diagnostic amylase is found to be 10%. The most common cause after gallstones is idiopathic together with hyperlipidemia. The outcome is usually favorable provided the diagnosis is not delayed.