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Related Experiment Videos

Amylase and gut infarction.

C Wilson, C W Imrie

    The British Journal of Surgery
    |March 1, 1986
    PubMed
    Summary

    Serum amylase levels are often normal in patients with acute mesenteric infarction. Elevated amylase, especially in the acute pancreatitis range, can lead to misdiagnosis and inappropriate treatment for bowel infarction.

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    Area of Science:

    • Gastroenterology
    • Surgical Pathology

    Background:

    • Acute mesenteric infarction is a surgical emergency with high mortality.
    • Elevated serum amylase is a common finding in abdominal emergencies, often associated with acute pancreatitis.

    Purpose of the Study:

    • To evaluate the diagnostic utility of serum amylase levels in patients with acute mesenteric infarction.
    • To determine the correlation between serum amylase levels and the extent of bowel infarction.

    Main Methods:

    • Serum amylase levels were measured on admission in 122 patients diagnosed with acute mesenteric infarction.
    • Patients were categorized based on amylase levels (normal, elevated, or in the acute pancreatitis range).
    • The extent of bowel infarction was assessed and correlated with amylase levels.

    Main Results:

    • Serum amylase was assessed in 63% of patients with acute mesenteric infarction.
    • Normal amylase levels were observed in 54% of patients.
    • Hyperamylasemia, including levels diagnostic for acute pancreatitis, was found in 24% of patients, leading to misdiagnosis and inappropriate non-operative management in some cases.
    • Higher amylase levels correlated with more extensive infarction, particularly involving the small bowel and colon.

    Conclusions:

    • Serum amylase is not a reliable diagnostic marker for acute mesenteric infarction.
    • Elevated amylase levels in the context of acute mesenteric infarction can mimic acute pancreatitis, leading to diagnostic errors and delayed surgical intervention.
    • The degree of hyperamylasemia may reflect the extent of bowel necrosis.

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