Reliable screening for acute pancreatitis with rapid urine trypsinogen-2 test strip

Background: This study was designed to evaluate the validity of a new rapid urinary trypsinogen-2 test strip (Actim Pancreatitis) for detection of acu te pancreatitis in patients with acute abdominal pain. Methods: A total of 525 consecutive patients presenting with abdominal pain at two emergency units was included prospectively and tested with the Acti m Pancreatitis test strip. Urine trypsinogen-2 concentrations were also det ermined by a quantitative method. The diagnosis and assessment of severity of acute pancreatitis was based on raised serum and urinary amylase levels, clinical features and findings on dynamic contrast-enhanced computed tomog raphy. Results: In 45 patients the diagnosis of acute pancreatitis could be establ ished. The Actim Pancreatitis test strip result was positive in 43 of them resulting in a sensitivity of 96 per cent. Thirty-seven false-positive Acti m Pancreatitis test strips were obtained in patients with non-pancreatic ab dominal pain resulting in a specificity of 92 per cent. Nine patients with severe acute pancreatitis were all detected by the dipstick. Conclusion: A negative Actim Pancreatitis strip result excludes acute pancr eatitis with high probability. Positive results indicate the need for furth er evaluation, i.e. other enzyme measurements and/or radiological examinati ons. The test is easy and rapid to perform, unequivocal in its interpretati on and can be used in healthcare units lacking laboratory facilities.