title: Association of acute pancreatitis or high level of serum pancreatic enzymes in patients with acute spinal cord injury: a prospective study.
abstract: BACKGROUND
  Spinal cord injuries has increased together with urban violence and show a high rates of incidence. Besides the onus to patient and society, it can also cause other serious complications to victims. Acute pancreatitis has an important impact on this disease and has been underdiagnosed in several patients.
  
  
  OBJECTIVE
  The aim of this study was investigate the association of acute pancreatitis in acute spinal cord injuries. The secondary aim was to propose an investigation protocol to early diagnose and prevent it.
  
  
  METHODS
  A prospective observational study was conducted in 78 patients who presented acute spinal cord injury (SCI) at our emergency department, confirmed by clinical and imaging examination, in according to the American Spinal Injury Association (ASIA) Classification. Exclusion criteria were chronic or associate diseases in spinal cord, pancreatic direct trauma, alcoholism and chronic pancreatic disease.
  
  
  RESULTS
  The association of acute pancreatitis in patients with SCI was 11.53%. The occurrence of pancreatitis or high levels of serum pancreatic enzymes in patients with ASIA A was 41.7% and only 4.17% in patients with ASIA E. In all, 55.2% of patients who presented pancreatitis or high levels of serum pancreatic enzymes had cervical level of SCI and 34.5% had thoracic level. Adynamic ileus was observed in 68.96% of this group.
  
  
  CONCLUSIONS
  We concluded that, in acute spinal cord injuries, the occurrence of acute pancreatitis or high serum levels of pancreatic enzymes are more frequent in patients with ASIA A Classification, cervical/thoracic level of spinal injury and adynamic ileus.
authors.affiliation: Spaulding Rehabilitation Network Laboratory, Harvard Medical School, Charlestown, MA, USA.
authors.forename: E H
authors.initials: EH
authors.lastname: Pirolla
authors.affiliation: Department of Orthopedic Surgery, University of São Paulo, São Paulo, Brazil.
authors.forename: T E P
authors.initials: TE
authors.lastname: de Barros Filho
authors.affiliation: Department of Orthopedic Surgery, University of São Paulo, São Paulo, Brazil.
authors.forename: A L
authors.initials: AL
authors.lastname: Godoy-Santos
authors.affiliation: Spaulding Rehabilitation Network Laboratory, Harvard Medical School, Charlestown, MA, USA.
authors.forename: F
authors.initials: F
authors.lastname: Fregni
mesh_terms: D000208:Acute Disease; D000328:Adult; D000681:Amylases / Q000097:blood*; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology; D006801:Humans; D008049:Lipase / Q000097:blood*; D008297:Male; D010195:Pancreatitis / Q000097:blood* / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D011446:Prospective Studies; D013119:Spinal Cord Injuries / Q000145:classification / Q000150:complications*
chemical_list: D008049:Lipase; D000681:Amylases