ISOENZYME ANALYSIS OF HYPERAMYLASEMIA ASSOCIATED WITH RUPTURED ABDOMINAL AORTIC-ANEURYSMS

Hyperamylasaemia may occur following abdominal aortic aneurysm rupture and its use as a prognostic indicator has been suggested. However, th e isoenzyme responsible for the rise in serum amylase has not been inv estigated. In this study, isoenzyme analysis was performed on the seru m of patients noted to have a raised amylase from their routine bioche mistry samples. Individual cases cr ere then reviewed regarding clinic al course and outcome. The pancreas has been thought to be the predomi nant source of the observed hyperamylasaemia. However, in this study a mixed picture of pancreatic and salivary isoenzymes was found. Of the four highest recorded amylase levels two were salivary ill origin, on e pancreatic and one mixed. The highest recorded amylase level was of salivary origin in a patient that survived without any major complicat ion. The four patients that died all showed evidence of gut infarction /ischaemia. Two had hyperamylasaemia of a mixed pattern, one pancreati c and one of salivary origin.