title: Role of biochemical investigation in prediction of biliary etiology in acute pancreatitis.
abstract: BACKGROUND
  Acute pancreatitis is common clinical presentation. Gall stone disease and alcohol consumption are most common etiologies. Detection of biliary etiology is important in order to provide definite management in form of cholecystectomy to prevent further attacks. Sensitivity for abdominal ultrasound to detect cholelithiasis is decreased to 67-87% in presence of acute pancreatitis. Difference in biochemical investigations of acute biliary and non-biliary pancreatitis has been proposed to increase the suspicion of biliary etiology.
  
  
  METHODS
  Sixty patients admitted with diagnosis of acute pancreatitis from March 2012 to December 2012 were included in the study. The relation between etiology with age, sex, admission serum amylase and liver function test were evaluated.
  
  
  RESULTS
  Out of 60 patients 38 (63.33%) and 22 (36.66%) had biliary and non-biliary etiology respectively. Biliary pancreatitis was more common in females (25 vs. 3). Distribution of severity was comparable between both groups. Biliary pancreatitis group had significantly higher amylase level (3466.42 vs. 1987.5, p 0.003) whereas values of liver function test were higher in biliary pancreatitis though not statistically significant.
  
  
  CONCLUSIONS
  A simple, rapid and accurate prediction of biliary etiology of acute pancreatitis can be provided by changes in biochemical parameters.
authors.affiliation: Department of Surgery, Kathmandu Medical College Teaching Hospital, Sinamangal, Kathmandu, Nepal.
authors.forename: Tanka Prasad
authors.initials: TP
authors.lastname: Bohara
authors.forename: Anuj
authors.initials: A
authors.lastname: Parajuli
authors.forename: Mukund Raj
authors.initials: MR
authors.lastname: Joshi
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000378:metabolism; D000469:Alkaline Phosphatase / Q000378:metabolism; D000681:Amylases / Q000378:metabolism; D001219:Aspartate Aminotransferases / Q000378:metabolism; D001663:Bilirubin / Q000378:metabolism; D002769:Cholelithiasis / Q000150:complications* / Q000175:diagnosis* / Q000378:metabolism; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008049:Lipase / Q000378:metabolism; D008111:Liver Function Tests; D008297:Male; D009390:Nepal; D010195:Pancreatitis / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism*; D011237:Predictive Value of Tests
chemical_list: D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D008049:Lipase; D000469:Alkaline Phosphatase; D000681:Amylases; D001663:Bilirubin
keywords: Acute Pancreatitis, Biliary Pancreatitis, Serum Amylase.