Pancreatitis pp 65-101 | Cite as

Diagnosis of Acute Pancreatitis

  • Peter A. Banks
Part of the Topics in Gastroenterology book series (PEPE, volume 2)

Abstract

Alpha amylase is an enzyme that splits the α-1, 4-glycosidic bonds of starch. Its optimal pH is 6.9. Its molecular weight is approximately 50,000. Chloride is required for optimal enzyme activity. Calcium is an integral part of the enzyme.

Keywords

Starch Magnesium Creatinine Radium Morphine 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Skude G: Sources of the serum isoamylases and their normal range of variation with age. Scand J Gastroenterol 10: 577–584, 1975.PubMedGoogle Scholar
  2. 2.
    Warshaw AL, Lee K-H: Characteristic alterations of serum isoenzymes of amylase in diseases of liver, pancreas, salivary gland, lung, and genitalia. J Surg Res 22: 362–369, 1977.PubMedGoogle Scholar
  3. 3.
    Shimamura J, Fridhandler L, Berk JE: Does human pancreas contain salivary-type isoamylase? Gut 16: 1006–1009, 1975.PubMedGoogle Scholar
  4. 4.
    Warshaw AL, Lee L-H: The mechanism of increased renal clearance of amylase in acute pancreatitis. Gastroenterology 71: 388–391, 1976.Google Scholar
  5. 5.
    Long WB, Grider JR Jr: Amylase isoenzyme clearances in normal subjects and in patients with acute pancreatitis. Gastroenterology 71: 589–593, 1976.PubMedGoogle Scholar
  6. 6.
    Levitt MD, Ellis C, Engel RR: Isoelectric focusing studies of human serum and tissue isoamlases. J Lab Clin Med 90: 141–152, 1977.PubMedGoogle Scholar
  7. 7.
    Duane WC, Frerichs R, Levitt MD: Distribution, turnover, and mechnism of renal excretion of amylase in the baboon. J Clin Invest 50: 156–165, 1971.PubMedGoogle Scholar
  8. 8.
    Schonebeck J, Soderberg M: Serum amylase in renal failure. Scand J Urol Nephrol 5: 257–262, 1971.PubMedGoogle Scholar
  9. 9.
    Blainey JD, Northam BE: Amylase excretion by the human kidney. Clin Sei 32: 377–383, 1967.Google Scholar
  10. 10.
    Morton WJ, Tedesco FJ, Harter HR, et al: Serum amylase determinations and amylase to creatinine clearance ratios in patients with chronic renal insufficiency. Gastroenterology 71: 594–598, 1976.Google Scholar
  11. 11.
    Levitt MD, Rapoport M, Cooperband SR: The renal clearance of amylase in renal insufficiency, acute pancreatitis, and macroamylasemia. Ann Intern Med 71: 919–925, 1969.PubMedGoogle Scholar
  12. 12.
    Seward CW: Diagnosing pancreatitis the first day: a comparison of urinary amylase and serum enzymes in pancreatic dysfunction. South Med J 63: 286–289, 1970.PubMedGoogle Scholar
  13. 13.
    Salt WB II, Schenker S: Amylase—its clinical significance. Medicine 55: 269–289, 1976.PubMedGoogle Scholar
  14. 14.
    Levitt MD, Johnson SG, Ellis CJ, et al: Influence of amylase assay technique on renal clearance of amylase-creatinine ratio. Gastroenterology 72: 1260–1263, 1977.PubMedGoogle Scholar
  15. 15.
    Lifton LJ, Slickers KA, Pragay DA, et al: Pancreatitis and lipase. JAMA 229: 47–50, 1974.PubMedGoogle Scholar
  16. 16.
    Song H, Tietz NW, Tan C: Usefulness of serum lipase, esterase, and amylase estimation in the diagnosis of pancreatitis—a comparison. Clin Chem 16: 264–268, 1970.PubMedGoogle Scholar
  17. 17.
    Albo R, Silen W, Goldman L: A clinical analysis of acute pancreatitis. Arch Surg 86: 1032–1038, 1963.PubMedGoogle Scholar
  18. 18.
    Warshaw AL, Fuller AF Jr: Specificity of increased renal clearance of amylase in diagnosis of acute pancreatitis. N Engl J Med 292: 325–328, 1975.PubMedGoogle Scholar
  19. 19.
    Sherr HP, Light RW, Merson MH, et al: Origin of pleural fluid amylase in esophageal rupture. Ann Intern Med 76: 985–986, 1972.PubMedGoogle Scholar
  20. 20.
    Patt HH, Kramer SP, Woel G, et al: Serum lipase determination in acute pancreatitis. Arch Surg 92: 718–723, 1966.PubMedGoogle Scholar
  21. 21.
    Warshaw AL, Bellini CA, Lee K-H; Electrophoretic identification of an isoenzyme of amylase which increases in serum in liver diseases. Gastroenterology 70: 572–576, 1976.PubMedGoogle Scholar
  22. 22.
    MacGregor IL, Zakim D: A cause of hyperamylasemia associated with chronic liver disease. Gastroenterology 72: 519–523, 1977.PubMedGoogle Scholar
  23. 23.
    Lehrner LM, Ward JC, Karn RC, et al: An elevation of the usefulness of amylase isozyme differentiation in patients with hyperamylasemia. AJCP 66: 576–587, 1976.PubMedGoogle Scholar
  24. 24.
    Ammann RW, Berk E, Fridhandler L, et al: Hyperamylasemia with carcinoma of the lung. AnnlntMed78: 521–525, 1973.Google Scholar
  25. 25.
    Berk JE, Shimamura J, Fridhandler L: Hyperamylasemia associated with cancer. Gastroenterology 73: A-6/1029, 1977.Google Scholar
  26. 26.
    Kitamura T, Yoshioka K, Ehara M, et al: A study on the nature of macroamylase complex. Gastroenterology73: 46–51, 1977.Google Scholar
  27. 27.
    Levitt MD, Cooperband SR: Hyperamylasemia from the binding of serum amylase by an 1 IS IgA globulin. N Engl J Med 278: 474–478, 1968.PubMedGoogle Scholar
  28. 28.
    Barrows D, Berk E, Fridhandler L: Macroamylasemia—survey of pre valance in a mixed population. N Engl J Med 286: 1352, 1972.PubMedGoogle Scholar
  29. 29.
    Berk JE, Kizu H, Wilding P et al: Macroamylasemia: a newly recognized cause for elevated serum amylase activity. N Engl J Med 277: 941–946, 1967.PubMedGoogle Scholar
  30. 30.
    Hedger RW, Hardison WGM: Transient macroamylasemia during an exacerbation of acute intermittent porphyria. Gastroenterology 60: 903–908, 1971.PubMedGoogle Scholar
  31. 31.
    Berggren T and Levitt MD: An unusual form of macroamylasemia. Gastroenterology 67: 149–154, 1974.PubMedGoogle Scholar
  32. 32.
    Pederson EB, Brock A, Kornerup HJ: Serum amylase activity and renal activity clearance in patient with severely impaired renal function and in patients treated with renal allotransplantation. Scand J Clin Lab Invest 36: 137–140, 1976.Google Scholar
  33. 33.
    Warshaw AL, Feller ER, Lee K-H: On the cause of raised serum-amylase in diabetic ketoacidosis. Lancet 1: 929–931, 1977.PubMedGoogle Scholar
  34. 34.
    Takagi H, Yasue M, Morimoto T, et al: Asymptomatic transient hyperamylasemia after a large intravenous dose of steroid hormone. Am J Surg 133: 322–325, 1977.PubMedGoogle Scholar
  35. 35.
    Henn RM, Selcon S, Sturdevant RAL, et al: Experience with synthetic secretin in the treatment of duodenal ulcer. Am J Dig Dis 21: 921–925, 1976.PubMedGoogle Scholar
  36. 36.
    Hanafy HM, Gursel EO, Veenema RJ: Increased serum amylase levels in prostatic disease. Urology 1: 372–373, 1973.PubMedGoogle Scholar
  37. 37.
    Skude G, Wehlin L, Maruyama T, et al: Hyperamylaseamia after duodenoscopy and retrograde cholangiopancreatography. Gut 17: 127–132, 1976.PubMedGoogle Scholar
  38. 38.
    Nardi GL: Remediable chronic pancreatitis. Surg Clin North Am 54: 613–620, 1974.PubMedGoogle Scholar
  39. 39.
    Saxon EI, Hinkley WC, Vogel WC, et al: Comparative value of serum and urinary amylase in the diagnosis of acute pancreatitis. Arch Intern Med 99: 607–621, 1957.Google Scholar
  40. 40.
    Johnson SG, Ellis CJ, Levitt MD: Mechanism of increased renal clearance of amylase/ creatinine in acute pancreatitis. N Engl J Med 295: 1214–1217, 1976.PubMedGoogle Scholar
  41. 41.
    Drelling DA, Leichtling JJ, Janowitz HD: The amylase-creatinine clearance ratio. Am J Gastroenterol 61: 290–296, 1974.Google Scholar
  42. 42.
    Murray WR, MacKay C: The amylase-creatinine clearance ratio in acute pancreatitis. Br J Surg 64: 189–191, 1977.PubMedGoogle Scholar
  43. 43.
    Duane WC, Frerichs R, Levitt MD: Simultaneous study of the metabolic turnover and renal excretion of salivary amylase-125I and pancreatic amylase-131I in the baboon. J Clinlnvest 51: 1504–1513, 1972.Google Scholar
  44. 44.
    Noda A: Renal handling of amylase: evidence for reabsorption by stop-flow analysis. Metabolism 21: 351–355, 1972.PubMedGoogle Scholar
  45. 45.
    Warshaw AL, Lesser RB: Amylase clearance in differentiating acute pancreatitis from peptic ulcer with hyperamylasemia. Ann Surg 181: 314–316, 1975.PubMedGoogle Scholar
  46. 46.
    Lesser RB, Warshaw AL: Differentiation of pancreatitis from common bile duct obstruction with hyperamylasemia. Gastroenterology 68: 636–641, 1975.PubMedGoogle Scholar
  47. 47.
    Berk JE, Fridhandler L, Montgomery K: Simulation of macroamylasemia by salivary-type (‘S type’) hyperamylasaemia. Gut 14: 726–729, 1973.PubMedGoogle Scholar
  48. 48.
    Warshaw AL: The kidney and changes in amylase clearance. Gastroenterology 71:702– 704, 1976.Google Scholar
  49. 49.
    Lesser PB, Warshaw AL: Diagnosis of pancreatitis masked by hyperlipemia. Ann Intern Med82:795–798, 1975.Google Scholar
  50. 50.
    Warshaw AL, Bellini CA, Lesser PB: Inhibition of serum and urine amylase activity in pancreatitis with hyperlipemia. Ann Surg 182: 72–75, 1975.PubMedGoogle Scholar
  51. 51.
    Donaldson LA, Mcintosh W, Joffe SN: Amylase creatinine clearance ratio after biliary surgery. Gut 18: 16–18, 1977.PubMedGoogle Scholar
  52. 52.
    Levine RI, Glauser FL, Berk JE: Enhancement of the amylase-creatinine clearance ratio in disorders other than acute pancreatitis. N Engl J Med 292: 329–332, 1975.PubMedGoogle Scholar
  53. 53.
    Watkins PJ: The effect of ketone bodies on the determination of creatinine. Clin Chim Acta 18: 191–196, 1967.PubMedGoogle Scholar
  54. 54.
    Sidi S, Warshaw AL, Banks PA: Amylase-creatinine clearance ratios and serum amylase isoenzymes in moderate renal insufficiency. Gastroenterology 74: 1094, 1978.Google Scholar
  55. 55.
    Skude G: Human amylase isoenzymes. Scand J Gastroenterol 12 (supp 44): 1–37, 1977.Google Scholar
  56. 56.
    Magid E, Horsing M, Rune SJ: On the qualification of isoamylases in serum and the diagnostic value of serum pancreatic type amylase in chronic pancreatitis. Scand J Gastroenterol 12: 621–627, 1977.PubMedGoogle Scholar
  57. 57.
    Warshaw AL: Serum amylase isoenzyme profiles as a differential index in disease. J Lab Clin Med 90: 1–3, 1977.PubMedGoogle Scholar
  58. 58.
    Fridhandler L, Berk JE, Montgomery K: Nature of isoamylases released, by acidification, from macroamylase complexes. Clin Chem 20: 26–29, 1974.PubMedGoogle Scholar
  59. 59.
    Skude G, Eriksson S: Serum isoamylases in chronic pancreatitis. Scand J Gastroenterol 11: 525–527, 1976.PubMedGoogle Scholar
  60. 60.
    Skude G, Ihse I: Isoamylases in pancreatic carcinoma and chronic relapsing pancreatitis. Scand J Gastroenterol 12: 53–57, 1977.PubMedGoogle Scholar
  61. 61.
    Light RW, Ball WC Jr: Glucose and amylase in pleural effusions. JAMA 225: 257–260, 1973.PubMedGoogle Scholar
  62. 62.
    Mitchell CE: Relapsing pancreatitis with recurrent pericardial and pleural effusions. Ann Intern Med60:1047–1053, 1964.Google Scholar
  63. 63.
    Edmondson HA, Berne CJ, Homann RE Jr, et al: Calcium, potassium, magnesium and amylase disturbances in acute pancreatitis. Am J Med 12: 34–42, 1952.PubMedGoogle Scholar
  64. 64.
    Finch WT, Sawyers JL, Schenker S: A prospective study to determine the efficacy of antibiotics in acute pancreatitis. Ann Surg 183: 667–671, 1976.PubMedGoogle Scholar
  65. 65.
    Feller JH, Brown RA, Toussaint GPM, et al: Changing methods in the treatment of severe pancreatitis. Am J Surg 127: 196–201, 1974.PubMedGoogle Scholar
  66. 66.
    Berk JE: Serum amylase and lipase. JAMA 199: 134–138, 1967.Google Scholar
  67. 67.
    Greenberger NJ, Hatch FT, Drummey GD, et al: Pancreatitis and hyperlipemia. Medicine 45: 161–174, 1966.Google Scholar
  68. 68.
    Mullin GT, Caperton EM, Crespin SR, et al: Arthritis and skin lesions resembling erythema nodosum in pancreatic disease. Ann Intern Med 68: 75–87, 1968.PubMedGoogle Scholar
  69. 69.
    Sileo AV, Chawla SK, LoPresti PA: Pancreatic ascites: diagnostic importance of ascitic lipase. Am J Dig Dis 20: 1110–1114, 1975.PubMedGoogle Scholar
  70. 70.
    Robertson GM Jr, Moore EW, Switz DM, et al: Inadequate parathyroid response in acute pancreatitis. N Engl J Med 294: 512–516, 1976.PubMedGoogle Scholar
  71. 71.
    Donowitz M, Hendler R, Spiro HM, et al: Glucagon secretion in acute and chronic pancreatitis. Ann Intern Med 83: 778–781, 1975.PubMedGoogle Scholar
  72. 72.
    Lukash WM, Bishop RP, Nielsen OF: Transaminase levels in acute pancreatitis and after secretin stimulation. JAMA 197: 927–929, 1966.PubMedGoogle Scholar
  73. 73.
    Weir GC, Lesser PB, Drop LJ, et al: The hypocalcemia of acute pancreatitis. Ann Intern Med 83: 185–189, 1975.PubMedGoogle Scholar
  74. 74.
    Edmondson HA, Berne CJ: Calcium changes in acute pancreatic necrosis. Surg, Gynecol Obstet 79: 240–243, 1944.Google Scholar
  75. 75.
    Geokas MC, Rinderknecht H, Walberg CB, et al: Methemalbumin in the diagnosis of acute hemorrhagic pancreatitis. Ann Intern Med81: 483–486, 1974.Google Scholar
  76. 76.
    Edmondson HA, Fields I A: Relation of calcium and lipids to acute pancreatic necrosis. Arch Intern Med 69: 177–190, 1942.Google Scholar
  77. 77.
    Storck G, Bjorntorp P: Chemical composition of fat necrosis in experimental pancreatitis in the rat. Scand J Gastroenterol 6: 225–230, 1971.PubMedGoogle Scholar
  78. 78.
    Estep H, Shaw WA, Watlington C, et al: Hypocalcemia due to hypomagnesemia and reversible parathyroid hormone unresponsiveness. J Clin Endocrinol 29: 842–848, 1969.Google Scholar
  79. 79.
    Hersh T, Siddique DA: Magnesium and the pancreas. Am J Clin Nutr 26: 362–366, 1973.PubMedGoogle Scholar
  80. 80.
    Hernandez I A, Powers SR, Frawley TF: The role of the parathyroid glands in calcium and magnesium metabolism in acute hemorrhagic pancreatitis. Surgery 50: 143–150, 1961.PubMedGoogle Scholar
  81. 81.
    Lim P, Jacob E: Magnesium status of alcoholic patients. Metabolism 21: 1045–1051, 1972.PubMedGoogle Scholar
  82. 82.
    Lim P, Jacob E: Tissue magnesium level in chronic diarrhea. Lab Clin Med 80: 313–321, 1972.Google Scholar
  83. 83.
    Muldowney FP, McKenna TJ, Kyle LH, et al: Parathormone-like effect of magnesium replenishment in steatorrhea. N Engl J Med 282: 61–68, 1970.PubMedGoogle Scholar
  84. 84.
    Suh SM, Tashjian AH Jr, Matsuo N, et al: Pathogenesis of hypocalcemia in primary hypomagnesemia: normal end-organ responsiveness to parathyroid hormone, impaired parathyroid gland function. J Clin Invest 52: 153–160, 1973.PubMedGoogle Scholar
  85. 85.
    Rude RK, Oldham SB, Singer FR: Functional hypoparathyroidism and parathyroid hormone end-organ resistance in human magnesium deficiency. J Clin Endocrinol 5: 209–224, 1976.Google Scholar
  86. 86.
    Gillquist J, Larsson J, Sjodahl R: Serum calcitonin in acute pancreatitis in man. Scand J Gastroenterol 12: 21–25, 1977.PubMedGoogle Scholar
  87. 87.
    Lim P, Jacob E: Magnesium deficiency in liver cirrhosis. Q J Med 41: 291–300, 1972.PubMedGoogle Scholar
  88. 88.
    Meyers MA, Evans JA: Effects of pancreatitis on the small bowel and colon: spread along mesenteric planes. Am J Roentgenol Radium Ther Nucl Med 119: 151–165, 1973.PubMedGoogle Scholar
  89. 89.
    Meyers MA: Roentgen significance of the phrenicocolic ligament. Radiology 95: 539–545, 1970.PubMedGoogle Scholar
  90. 90.
    Meyers MA: The spread and localization of acute intraperitoneal effusions. Radiology 95: 547–554, 1970.PubMedGoogle Scholar
  91. 91.
    Moreno G, Rivera HH: Evaluation of the gastrocolic space in 100 cases of acute pancreatitis. Radiology 118: 535–538, 1976.PubMedGoogle Scholar
  92. 92.
    Miller IM, Irving MH: The value of the plain abdominal roentgenogram in the diagnosis of acute pancreatitis. Am J Surg 123: 671–673, 1972.PubMedGoogle Scholar
  93. 93.
    Ounjian ZJ, Laing FC: Stratification in the gallbladder on intravenous cholangiography. Radiology 121: 591–593, 1976.PubMedGoogle Scholar
  94. 94.
    Roller RJ, Mallory A, Caruthers SB Jr, et al: Oral cholecystography after alcoholic pancreatitis. Gastroenterology 73: 218–220, 1977.PubMedGoogle Scholar
  95. 95.
    Reuter SR, Redman HC, Joseph RR: Angiographic findings in pancreatitis. Am J Roentgenol 107: 56–64, 1969.Google Scholar
  96. 96.
    White AF, Baum S, Buranasiri S: Aneurysms secondary to pancreatitis. Am J Roentgenol 127: 393–396, 1976.Google Scholar
  97. 97.
    Weill F, Schraub A, Eisenscher A, et al: Ultrasonography of the normal pancreas. Radiology 123: 417–423, 1977.PubMedGoogle Scholar
  98. 98.
    Doust BD, Pearce JD: Gray-scale ultrasonic properties of the normal and inflamed pancreas. Radiology 120: 653–657, 1976.PubMedGoogle Scholar
  99. 99.
    Walls WJ, Templeton AW: The ultrasonic demonstration of inferior vena caval compression: a guide to pancreatic head enlargement with emphasis on neoplasm. Radiology 123: 165–167, 1977.PubMedGoogle Scholar
  100. 100.
    Goldberg BB: Ultrasonic cholangiography. Radiology 118: 401–404, 1976.PubMedGoogle Scholar
  101. 101.
    Bartrum RJ Jr, Crow HC, Foote SR: Ultrasonic and radiographic cholecystography. N Engl J Med 296: 538–541, 1977.PubMedGoogle Scholar
  102. 102.
    Lawson TL: Gray scale cholecystosonography. Radiology 122: 247–251, 1977.PubMedGoogle Scholar
  103. 103.
    Wittenberg J, Ferrucci JT, Jr: Computed body tomography. Gastroenterology 74: 287–293, 1978.PubMedGoogle Scholar
  104. 104.
    Abrams HL, McNeil BJ: Medical implications of computed tomography (“Cat scanning”). N Engl J Med 298: 310–318, 1978.PubMedGoogle Scholar
  105. 105.
    Stanley RJ, Sagel SS, Levitt RG: Computed tomographic evaluation of the pancreas. Radiology 124: 715–722, 1977.PubMedGoogle Scholar
  106. 106.
    Haaga JR, Alfidi RJ, Havrilla TR, et al: Definitive role of C-T scanning of the pancreas: the second year’s experience. Radiology 124: 723–730, 1977.PubMedGoogle Scholar

Copyright information

© Plenum Publishing Corporation 1979

Authors and Affiliations

  • Peter A. Banks
    • 1
    • 2
    • 3
    • 4
  1. 1.Tufts University School of MedicineUSA
  2. 2.St. Elizabeth’s Hospital of BostonUSA
  3. 3.Harvard Medical SchoolUSA
  4. 4.Beth Israel HospitalBostonUSA

Personalised recommendations