Abstract

BackgroundElevated lipase is considered an important biomarker for pancreatitis. The aim of this study was to assess a potential correlation between elevated lipase and characteristic imaging findings, as per the well-established Modified CT Severity index (MCTSI). Materials and methodsThis retrospective, single centre cohort study reviewed the radiologic findings and medical records of 200 consecutive patients with elevated lipase values. Subgroups were then created categorizing patients into low lipase elevation, medium lipase elevation, and high lipase elevation groups. CT exams evaluated by a single fellowship trained radiologist was used to establish MCTSI criteria. ResultsStatistical significance was calculated by an independent statistician using a linear regression model which demonstrated a statistically significant correlation between the high lipase group, (≥600 U/L) and MCTSI with p-value of <0.05. No significant correlation existed between MCTSI and lipase values below 600 U/L. ConclusionsThe previously held notion that lipase values do not correlate with severity of pancreatitis does not hold true for lipase values ≥ 600 U/L. This suggests a likelihood of higher morbidity and may justify earlier use of contrast enhanced CT imaging in patients with pancreatitis whose lipase values are >600 U/L. This needs to be further validated with a multisite blinded prospective study.

Highlights

  • Elevated lipase is a common abnormality seen in patients with abdominal pain

  • This study evaluated for a potential correlation between elevated lipase and characteristic imaging findings as per the established Modified computed tomography (CT) Severity index (MCTSI) [6]

  • This study confirms the importance of CT with contrast for patients with elevated lipase levels (≥600 U/L)

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Summary

Introduction

Elevated lipase is a common abnormality seen in patients with abdominal pain. This finding is frequently accompanied by computed tomography (CT) imaging. The aim of this study was to assess a potential correlation between elevated lipase and characteristic imaging findings, as per the well-established Modified CT Severity index (MCTSI). Conclusions: The previously held notion that lipase values do not correlate with severity of pancreatitis does not hold true for lipase values ≥ 600 U/L This suggests a likelihood of higher morbidity and may justify earlier use of contrast enhanced CT imaging in patients with pancreatitis whose lipase values are > 600 U/L. This needs to be further validated with a multisite blinded prospective study

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