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ACUTE PANCREATITIS-INVESTIGATIONS

Gastroenterology

ACUTE PANCREATITIS-INVESTIGATIONS

1. Amylase and lipase are generally elevated. The serum amylase level is almost always elevated early on (> 3x N is almost always due to pancreatitis) but decreases within 2-3 days after disease onset.

2. The lipase level increases later and stays elevated longer than the amylase (beyond day 7).

3. Triglyceride levels > 1,000 mg/dL can cause pancreatitis.

4. In working up the cause of acute pancreatitis, the 1 st and often only imaging test is gallbladder ultrasonography to rule out gallstones.

5. The 2012 revision of the Atlanta classification for acute pancreatitis identifies that 2 of the following must be present:
a) Upper abdominal pain radiating through to the back
b) Serum amylase or lipase 3x the upper limit of normal
c) Cross sectional imaging consistent with acute pancreatitis


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REFERENCES

1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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