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Pancreatic involvement during the early phase of shock
Raffaele Pezzilli1, Antonio Maria Morselli-Labate, Elisabetta Romboli
1Dipartimento di Medicina Interna e Gastroenterologia, Ospedale Sant'Orsola, Università di Bologna, Bologna, Italy. pezzilli@orsola-malpighi.med.unibo.it
Background:
There is a lack of data concerning pancreatic involvement during shock.
Aim:
To evaluate possible pancreatic alterations in the early phase of shock.
Setting:
Twelve consecutive patients with shock were studied within 2 hours from the onset of illness. Seven patients died during the hospital stay: 3 within 4 hours from admission, 3 within 4-8 hours and 1 within 12 hours.
Main Outcome Measures:
Amylase, lipase, C-reactive protein, amyloid A, interleukin 6, procalcitonin and vascular cell adhesion molecule-1 serum concentrations were determined on admission and 4, 8, and 12 hours afterward. All patients underwent imaging studies of the pancreas.
Results:
None of the patients developed clinical signs or morphological alterations compatible with acute pancreatitis. Serum amylase levels were above the upper reference limit in 7 patients (58.3%) and serum lipase levels in 2 patients (16.7%; P=0.062). There were no significant differences found between survivors and non-survivors in the serum concentrations of all the proteins studied.
Conclusions:
In patients with shock, amylase seems to be more frequently elevated than lipase. None of the patients showed pancreatic alterations at imaging techniques.