title: Early assessment of acute pancreatitis. A comparative study of computed tomography and laboratory tests.
abstract: Because the severity of acute pancreatitis is difficult to assess in the early stage, analyses were made of the diagnostic specificity and sensitivity of computed tomography (CT), C-reactive protein (CRP), serum phospholipase A2 and other laboratory parameters. In a series of 88 patients with clinically suspected severe acute pancreatitis, statistically significant differences were found between mild and severe disease in regard to CRP (97.1 vs. 265.7 mg/l), contrast enhancement of the pancreas at CT (45.3 vs. 22.7 Hounsfield units) and phospholipase A2 activity (5.3 vs. 11.2 nmol FFA/ml min). No significant intergroup difference was found in number of prognostic signs (1.7 vs. 4.1) or in extrapancreatic scores at CT (4.4 vs. 6.4). The sensitivity/specificity of different methods in severe pancreatitis were as follows: Prognostic signs 77.5/75%, CRP (greater than 140 mg/l) 100/81%, phospholipase A2 (greater than 11 nmol FFA/ml min) 42/100%, extrapancreatic score at CT (greater than 4) 100/29%, and contrast enhancement of the pancreas (less than 30 HU) 66/100%. Amylase determination was nonspecific (2-4%). The outcome in acute pancreatitis was most accurately predictable with CT or CRP.
authors: Second Department of Surgery, Helsinki University Central Hospital, Finland.
authors: P A
authors: PA
authors: Puolakkainen
mesh_terms: D000208:Acute Disease; D000328:Adult; D000681:Amylases / Q000378:metabolism; D002097:C-Reactive Protein / Q000032:analysis; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000378:metabolism; D010741:Phospholipases A / Q000097:blood; D054467:Phospholipases A2; D011379:Prognosis; D013997:Time Factors; D014057:Tomography, X-Ray Computed
chemical_list: D002097:C-Reactive Protein; D010741:Phospholipases A; D054467:Phospholipases A2; D000681:Amylases