Pancreatitis

Key Information

Appropriate Tests

Acute pancreatitis

Lipase and/or Amylase (plasma or serum).

Amylase is less sensitive than Lipase and is only transiently increased.

High levels of Lipase and Amylase can occur in other causes of an 'acute abdomen'.

Amylase urine occasionally useful if clinical suspicion is high and levels of serum lipase and amylase are normal.

Causes

 

Alcoholism

 

Biliary disease

See Cholestasis

Hypertriglyceridaemia

See under Hyperlipidaemia

Mumps

Serological investigation is of no clinical value.

Drug reactions

  • Sulphonamides
  • Thiazide diuretics
  • Azathioprine

 

Trauma

 

Shock

 

Hypercalcaemia

 

Complications

 

Pancreatic abscess

Repeat serum Lipase or Amylase if a local pancreatic complication is suspected.

Blood culture if patient is febrile.

MCS pus (microscopy and culture) from operative site if surgical intervention (eg, drainage) is required.

Pancreatic pseudocyst

 

Chronic pancreatitis

See Malabsorption and Diabetes mellitus