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Prevalence of normal serum amylase levels in patients with acute alcoholic pancreatitis

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Abstract

Acute alcoholic pancreatitis is uncommonly diagnosed when the serum amylase level is normal. We defined acute alcoholic pancreatitis as a clinical syndrome in which hyperamylasemia was not a necessary component and sought support for the diagnosis by ultrasonography and computed tomography of the pancreas. In 68 episodes of acute alcoholic pancreatitis identified in a one-year period, the serum amylase level was normal at the time of hospital admission in 32%. In 40 episodes, we performed ultrasonography and computed tomography within 48 hr of admission. The diagnosis was supported by ultrasonography in 43%, by computed tomography in 68%. Ultrasonography and computed tomography supported the diagnosis as frequently in patients with normal serum amylase levels as in patients with hyperamylasemia. We conclude that patients with acute alcoholic pancreatitis frequently have normal serum amylase levels. The widespread clinical practice of relying solely on hyperamylasemia to establish the diagnosis of acute alocholic pancreatitis is unjustified and should be abandoned.

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Authors and Affiliations

  1. Department of Medicine, Radiology and Surgery, Boston Veterans Administration Medical Center, 150 South Huntington Avenue, 02130, Boston, Massachusetts

    Stuart Jon Spechler MD, John W. Dalton MD, Alan H. Robbins MD, Stephen G. Gerzof MD, Jerry S. Stern MD, Willard C. Johnson MD, Donald C. Nabseth MD & Elihu M. Schimmel MD

  2. Boston University School of Medicine, 02130, Boston, Massachusetts

    Stuart Jon Spechler MD, John W. Dalton MD, Alan H. Robbins MD, Stephen G. Gerzof MD, Jerry S. Stern MD, Willard C. Johnson MD, Donald C. Nabseth MD & Elihu M. Schimmel MD

  3. Tufts University School of Medicine, 02130, Boston, Massachusetts

    Stuart Jon Spechler MD, John W. Dalton MD, Alan H. Robbins MD, Stephen G. Gerzof MD, Jerry S. Stern MD, Willard C. Johnson MD, Donald C. Nabseth MD & Elihu M. Schimmel MD

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  1. Stuart Jon Spechler MD
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  2. John W. Dalton MD
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  3. Alan H. Robbins MD
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  4. Stephen G. Gerzof MD
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  5. Jerry S. Stern MD
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  6. Willard C. Johnson MD
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  7. Donald C. Nabseth MD
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  8. Elihu M. Schimmel MD
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Spechler, S.J., Dalton, J.W., Robbins, A.H. et al. Prevalence of normal serum amylase levels in patients with acute alcoholic pancreatitis. Digest Dis Sci 28, 865–869 (1983). https://doi.org/10.1007/BF01317034

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  • DOI: https://doi.org/10.1007/BF01317034

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