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Overview :
Acute pancreatitis can be diagnosed by using an algorithm
for the pattern of laboratory test findings.
Algorithm
If amylase > 2 times the upper limit of normal, then
measure lipase.
If lipase is within normal range, perform isoamylase
electropheresis. This will distinguish between macroamylasemia and an increased
amylase from an extrapancreatic source (salivary pattern).
If lipase is increased but less than 5 times the upper limit
of normal, then measure serum creatinine.
• If serum
creatinine is increased to more than 2 times the upper limit of normal, then
the increases reflect renal insufficiency.
• If serum
creatinine is less than 2 times the upper limit of normal, then the patient
either has late acute pancreatitis or else some other intra-abdominal disorder.
If lipase is increased more than 5 times the upper limit of
normal, then acute pancreatitis is present.
Limitations:
• Amylase may
not be elevated at presentation and may return quickly to normal.
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