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Serum amylase determinations in pediatric patients presenting to the ED with acute abdominal pain or trauma

H K Simon1, A Muehlberg, J G Linakis

  • 1Department of Pediatrics, Rhode Island Hospital, Brown University, Providence 02903.

The American Journal of Emergency Medicine
|May 1, 1994
PubMed

Insights

Serum amylase testing has minimal impact on managing pediatric emergency department patients with abdominal pain or trauma. Elevated levels rarely altered patient admission or treatment plans, indicating limited clinical utility.

Area of Science:

  • Pediatric Emergency Medicine
  • Clinical Chemistry
  • Diagnostic Utility

Background:

  • Acute abdominal pain and trauma are common presentations in pediatric emergency departments.
  • Serum amylase is a commonly ordered test in these scenarios.
  • The diagnostic and clinical impact of serum amylase in this population requires evaluation.

Purpose of the Study:

  • To assess the impact of serum amylase determinations on the initial management of pediatric patients with acute abdominal pain or trauma.
  • To determine the rate of elevated serum amylase levels in this patient cohort.
  • To evaluate if serum amylase results influenced admission status or clinical decisions.

Main Methods:

  • Retrospective review of pediatric emergency department cases over 18 months.
  • Inclusion criteria: patients under 18 with serum amylase testing for abdominal pain or trauma.
  • Data collected: amylase levels, demographics, presenting complaint, diagnosis, and management outcomes.

Main Results:

  • 656 patients met criteria; 1.8% had elevated serum amylase.
  • Elevated amylase occurred in 3.0% of trauma cases and 1.0% of abdominal pain cases.
  • Serum amylase levels did not influence hospital admission decisions for most patients.

Conclusions:

  • Serum amylase testing has a low yield in the initial evaluation of pediatric abdominal pain and trauma.
  • Clinical management was affected in only 2 cases, both involving subacute pain and trauma.
  • Further investigation into the specific utility of amylase in select pediatric cases may be warranted.

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