J.Jpn. Surg. Soc.. 96(7): 456-465, 1995
Original article
THE RELIABILITY AND THE SIGNIFICANCE OF SERUM AMYLASE LEVELS IN THE DIAGNOSIS OF THE PANCREATIC INJURY
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1) Department of Emergency and Critical Care Medicine, Kitasato University, School of Medicine, Sagamihara, Japan Tsunemasa Takishima1), Katsuhiko Sugimoto1), Yasushi Asari1), Takaaki Kikuno1), Mitsuhiro Hirata1), Akira Kakita2), Takashi Owada1) |
The elapsed time between injury and arrival of the hospital (ETAI) in the patients with normal SAL (1.3±0.2 hours, mean±SE) was significantly shorter than those with hyperamylasemia (5.8±0.9 hours), SAL on arrival significantly correlated to ETAI in the patients with type I (contusion) and type III injury (ductal injury).
Among 45 patients who had arrived over 3 hours after injury, none showed normal SAL. Regardless of severity of Pls, one third of the patients showed normal SAL on arrival within 3 hours after injury.
Among 23 patients treated conservatively, SAL in 14 patients (60.9%) normalized within 48 hours after injury, and these patients had no complications related to PIs. Three of remaining 9, who had prolonged hyperamylasemia over 48 hours, had pancreatic ductal branch injury or pseudocysts. This frequency was significantly different compared to that in the patients whose SAL normalized within 48 hours after injury.
In conclusion, SAL is unreliable and insignificant to diagnose PIs within 3 hours after injury. Not to overlook the PIs serologically, it is important to determine SAL over 3 hours after injury especially in the patients having stable vital signs and to whom PIs are strongly suspected clinically.
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