RAPID URINE TRYPSINOGEN-2 DIPSTICK ASSAY TO DIAGNOSE ACUTE PANCREATITIS IN EMERGENCY SETUP

Abstract

Background: Early diagnosis of acute pancreatitis remains a challenge in emergency set up. The early management results in better outcomes but none of the available investigations were rapid and accurate to guide the management in these patients. Hence in suspected cases of acute pancreatitis, the urinary trypsinogen 2 dipstick assay can be used to diagnose them at the earliest in the Emergency setup. The purpose of this study is to determine the accuracy of urine trypsinogen 2 assay in diagnosing acute pancreatitis. Methods: The patients presenting with symptoms consistent with acute pancreatitis to the emergency department, at a tertiary care hospital in Southern India between November 2018 to November 2019 were included in a prospective observational study after obtaining Institutional ethical committee clearance. In addition to the routine investigations done in cases of acute abdomen, patients underwent urine trypsinogen 2 dipstick test. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) were calculated. Results were compared. Results: A total of 50 cases were included in the study. The urine trypsinogen 2 dipstick test was positive in 35 of 37 patients with acute pancreatitis (sensitivity, 94.59%) and in none of 13 patients with abdominal pain but without any evidence of acute pancreatitis (specificity, 100%). The diagnostic accuracy of the urine trypsinogen 2 dipstick test was 96% in this study higher than other conventional laboratory investigations. Conclusion: This study shows that the dipstick test has high diagnostic accuracy and can be considered for regular use for diagnosing pancreatitis along with the conventional methods.