SERUM LIPASE LEVELS IN NONPANCREATIC ABDOMINAL-PAIN VERSUS ACUTE-PANCREATITIS

Objective: 1) To determine whether serum lipase is elevated in patient s with nonpancreatic abdominal pain, and 2) to compare the levels of s erum lipase and serum amylase found in patients with nonpancreatic abd ominal pain with those found in acute pancreatitis in order to differe ntiate between the two groups. Methods: Serum lipase and amylase level s were estimated in 95 patients with nonpancreatic abdominal pain (gro up A). These levels were then compared with those found in 75 patients with acute pancreatitis (group P). Results: Serum amylase in group A ranged from 11 to 416 U/1, [mean 58 +/- 46 (SD)]. Three patients (3.3% ) had raised amylase levels. The maximum elevation noted in this group was 416 U/L. Serum amylase in group P ranged from 124 to 13,000 U/L ( mean 1620 +/- 1976). Twenty of the 75 patients (27%) in group P had le vels that overlapped those found in group A. The serum lipase in group A ranged from 3 to 680 U/L (mean 111 +/- 101). Ten of the 93 patients (11%) had elevated lipase levels. The maximum elevation noted was rou ghly 3 times normal (680 U/L). Serum lipase in group P ranged from 711 to 31,153 (mean 6705 +/- 7022). None of the patients in group P had l evels that overlapped those found in group A. The sensitivity of a ser um lipase level > 3 normal in detecting acute pancreatitis was 100% an d the specificity was 99%. The corresponding figures for serum amylase were 72% and 99%, respectively. Conclusion: A serum lipase level > 3 normal has a better diagnostic accuracy than serum amylase in differen tiating nonpancreatic abdominal pain from acute pancreatitis.