Pancreatic-type hyperamylasemia and hyperlipasemia secondary to ruptured ovarian cyst: a case report and review of the literature.
BACKGROUND
Although salivary-type hyperamylasemia is known to occur with ovarian pathologies such as salpingitis and adenocarcinoma, pancreatic-type hyperamylasemia and hyperlipasemia are considered to be highly specific for pancreatitis.


OBJECTIVE
To discuss the interpretation of hyperamylasemia in the context of acute abdominal pain, implications for management, and to review the literature relating to non-pancreatic causes of hyperamylasemia and hyperlipasemia.


METHODS
We present the case of a 25-year-old woman who presented with an acute abdomen and a markedly elevated pancreatic-type amylase and lipase in whom acute pancreatitis was suspected. Further investigations showed that the underlying pathology was actually a ruptured ovarian cyst causing massive intra-abdominal hemorrhage and necessitating emergency laparotomy.


CONCLUSIONS
This case represents an initial report of pancreatic-type hyperamylasemia and hyperlipasemia occurring with ovarian pathology and hemoperitoneum. Although these derangements may have been secondary to peritoneal irritation, this case raises the possibility that ovarian tissue is able to secrete large amounts of pancreatic-type amylase and lipase in addition to salivary-type amylase. Clinicians should be aware that simultaneous elevations of both enzymes are not necessarily pathognomic of acute pancreatitis.
Sinha
Sidhartha
S
Southend University Hospital NHS Foundation Trust, Essex, UK.
Khan
Hamed
H
Timms
Peter M
PM
Olagbaiye
Olufemi A
OA
D000006:Abdomen, Acute / Q000209:etiology; D000328:Adult; D000681:Amylases / Q000737:chemistry; D003937:Diagnosis, Differential; D005260:Female; D006470:Hemorrhage / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D034321:Hyperamylasemia / Q000209:etiology*; D008049:Lipase / Q000097:blood*; D010048:Ovarian Cysts / Q000150:complications* / Q000000981:diagnostic imaging*; D010195:Pancreatitis / Q000097:blood / Q000175:diagnosis*; D011859:Radiography; D012422:Rupture, Spontaneous / Q000150:complications / Q000000981:diagnostic imaging
D008049:Lipase; D000681:Amylases