Diagnosis of acute pancreatitis.
There is no golden standard for the diagnosis of acute pancreatitis (AP). The diagnosis is currently based on clinical presentation, measurement of released pancreatic enzymes and imaging studies. Serum/urinary amylase, lipase and trypsinogen-2 dipstick are the most applicable methods in the clinical practice largely because of their simple, rapid, inexpensive and readily available assay methods. In addition to the clinical picture, inflammatory markers (CRP) or contrast enhanced CT can be used to assess the severity of acute pancreatitis. Multifactorial scoring systems (Ranson's prognostic signs, APACHE II, MOF-score) may be too cumbersome for clinical practice. Patient history, determination of AST, bilirubin and alkaline phosphatase levels as well as imaging studies such as ultrasonography and ERCP can be used to distinguish between biliary and non-biliary origin of the disease.
Kemppainen
E
E
Department of Surgery, Helsinki University Central Hospital, Finland. esko.kemppainen@huch.fi
Puolakkainen
P
P
Leppäniemi
A
A
Hietaranta
A
A
Grönroos
J
J
Haapiainen
R
R
D000208:Acute Disease; D000681:Amylases / Q000378:metabolism; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003937:Diagnosis, Differential; D006801:Humans; D008049:Lipase / Q000378:metabolism; D010195:Pancreatitis / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism; D011379:Prognosis; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D014357:Trypsin; D014362:Trypsinogen / Q000378:metabolism
C064831:PRSS2 protein, human; D014362:Trypsinogen; D008049:Lipase; D000681:Amylases; D014357:Trypsin