title: Trypsinogen activation peptides (TAP) concentrations in the peritoneal fluid of patients with acute pancreatitis and their relation to the presence of histologically confirmed pancreatic necrosis.
abstract: This study measured the volume and colour, as well as concentrations of trypsinogen activation peptides (TAP) in the peritoneal fluid of 22 patients with acute pancreatitis and related these findings to the presence of pancreatic necrosis. Nine patients had a severe attack with histologically confirmed pancreatic necrosis, seven a severe attack without confirmed necrosis, and six a mild attack, also without confirmed necrosis. A free fluid volume > 20 ml or free fluid colour > grade 5 on the Leeds chart, or both detected histologically confirmed pancreatic necrosis with a sensitivity of 100% and specificity of 31%. A total peritoneal fluid TAP concentration of > or = nmol detected histologically confirmed pancreatic necrosis with a sensitivity of 89% and specificity of 85%, figures comparable with contrast enhanced computed tomography. These findings suggest that the measurement of peritoneal fluid TAP concentrations can detect effectively histologically confirmed pancreatic necrosis and that such measurements may prove useful in the selection of patients for surgery.
authors.affiliation: Department of Surgery, Glasgow Royal Infirmary.
authors.forename: D I
authors.initials: DI
authors.lastname: Heath
authors.forename: C
authors.initials: C
authors.lastname: Wilson
authors.forename: A M
authors.initials: AM
authors.lastname: Gudgeon
authors.forename: A
authors.initials: A
authors.lastname: Jehanli
authors.forename: A
authors.initials: A
authors.lastname: Shenkin
authors.forename: C W
authors.initials: CW
authors.lastname: Imrie
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000681:Amylases / Q000097:blood; D001202:Ascitic Fluid / Q000737:chemistry*; D015415:Biomarkers; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D009842:Oligopeptides / Q000032:analysis*; D010179:Pancreas / Q000473:pathology*; D010195:Pancreatitis / Q000201:enzymology / Q000378:metabolism* / Q000473:pathology; D011446:Prospective Studies; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D009842:Oligopeptides; C080396:trypsinogen activation peptide; D000681:Amylases