Pancreatic involvement during the early phase of shock.
BACKGROUND
There is a lack of data concerning pancreatic involvement during shock.


OBJECTIVE
To evaluate possible pancreatic alterations in the early phase of shock.


METHODS
Twelve consecutive patients with shock were studied within 2 hours from the onset of illness. Seven patients died during the hospital stay: 3 within 4 hours from admission, 3 within 4-8 hours and 1 within 12 hours.


METHODS
Amylase, lipase, C-reactive protein, amyloid A, interleukin 6, procalcitonin and vascular cell adhesion molecule-1 serum concentrations were determined on admission and 4, 8, and 12 hours afterward. All patients underwent imaging studies of the pancreas.


RESULTS
None of the patients developed clinical signs or morphological alterations compatible with acute pancreatitis. Serum amylase levels were above the upper reference limit in 7 patients (58.3%) and serum lipase levels in 2 patients (16.7%; P=0.062). There were no significant differences found between survivors and non-survivors in the serum concentrations of all the proteins studied.


CONCLUSIONS
In patients with shock, amylase seems to be more frequently elevated than lipase. None of the patients showed pancreatic alterations at imaging techniques.
Pezzilli
Raffaele
R
Dipartimento di Medicina Interna e Gastroenterologia, Ospedale Sant'Orsola, Università di Bologna, Bologna, Italy. pezzilli@orsola-malpighi.med.unibo.it
Morselli-Labate
Antonio Maria
AM
Romboli
Elisabetta
E
Dibenedetti
Francesco
F
Massa
Margherita
M
Migliori
Marina
M
Barakat
Bahjat
B
Merlini
Giampaolo
G
Corinaldesi
Roberto
R
Melzi d'Eril
Gian Vico
GV
D000368:Aged; D000369:Aged, 80 and over; D000681:Amylases / Q000097:blood; D005260:Female; D006801:Humans; D008049:Lipase / Q000097:blood; D008297:Male; D010179:Pancreas / Q000201:enzymology / Q000503:physiopathology*; D012769:Shock / Q000097:blood / Q000201:enzymology / Q000401:mortality / Q000503:physiopathology*
D008049:Lipase; D000681:Amylases