The purpose of this retrospective study, from the University of Tennessee College of Medicine, was to assess the effect of extrapancreatic causes of acute abdominal pain on serum amylase and lipase levels, and to determine which test was more predictive of pancreatic disease. Medical records of all adult patients admitted through the emergency department with acute abdominal pain over a 1-year period were reviewed. Patients were categorized according to anatomic location of demonstrated pathology. Records of 306 patients with acute abdominal pain were identified. Elevations of amylase or lipase greater than three times the upper limit of normal were 99 and 98 percent specific, respectively, for acute pancreatitis.
Serum lipase has the higher diagnostic efficiency and is the preferred test.
Previous studies have reached similar conclusions. Other studies have also agreed with these authors that lipase is more sensitive than amylase for acute pancreatitis. Unfortunately, the strength of this present study is vitiated by its retrospective design, inclusion of only hospitalized patients, and exclusion from analysis of patients without radiological or surgical demonstration of acute pancreatitis. The University of Utah has clinical photographs of acute pancreatitis and pancreatic pseudocyst . It is not a substitute for careful analysis of the original literature, and neither provides nor is intended to provide the basis for patient evaluation or treatment.