TRYPSINOGEN ACTIVATION PEPTIDES (TAP) CONCENTRATIONS IN THE PERITONEAL-FLUID OF PATIENTS WITH ACUTE-PANCREATITIS AND THEIR RELATION TO THE PRESENCE OF HISTOLOGICALLY CONFIRMED PANCREATIC NECROSIS
Di. Heath et al., TRYPSINOGEN ACTIVATION PEPTIDES (TAP) CONCENTRATIONS IN THE PERITONEAL-FLUID OF PATIENTS WITH ACUTE-PANCREATITIS AND THEIR RELATION TO THE PRESENCE OF HISTOLOGICALLY CONFIRMED PANCREATIC NECROSIS, Gut, 35(9), 1994, pp. 1311-1315
This study measured the volume and colour, as well as concentrations o
f trypsinogen activation peptides (TAP) in the peritoneal fluid of 22
patients with acute pancreatitis and related these findings to the pre
sence of pancreatic necrosis. Nine patients had a severe attack with h
istologically confirmed pancreatic necrosis, seven a severe attack wit
hout confirmed necrosis, and six a mild attack, also without confirmed
necrosis. A free fluid volume >20 ml or free fluid colour >grade 5 on
the Leeds chart, or both detected histologically confirmed pancreatic
necrosis with a sensitivity of 100% and specificity of 31%. A total p
eritoneal fluid TAP concentration of greater than or equal to 96 nmol
detected histologically confirmed pancreatic necrosis with a sensitivi
ty of 89% and specificity of 85%, figures comparable with contrast enh
anced computed tomography. These findings suggest that the measurement
of fluid TAP concentrations can detect effectively histologically con
firmed pancreatic necrosis and that such measurements may prove useful
in the selection of patients for surgery.