The predictive role of amylase and lipase levels on pancreas injury diagnosis in patients with blunt abdominal trauma

Seyed Mohammad Hosseininejad; Farzad Bozorgi; Touraj Assadi; Seyyed Hosein Montazar; Fatemeh Jahanian; Vahid Hoseini; Mahboobeh Shamsaee; Mohammad Tabarestani

doi:10.1515/hmbci-2019-0066

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Article

The predictive role of amylase and lipase levels on pancreas injury diagnosis in patients with blunt abdominal trauma

Seyed Mohammad Hosseininejad , Farzad Bozorgi , Touraj Assadi , Seyyed Hosein Montazar , Fatemeh Jahanian , Vahid Hoseini , Mahboobeh Shamsaee and Mohammad Tabarestani

Published/Copyright: May 6, 2020

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From the journal Hormone Molecular Biology and Clinical Investigation Volume 41 Issue 3

Abstract

Objectives

Despite the low incidence of pancreatic injury in the abdominal blunt trauma (BTA), its early diagnosis is very important; since pancreatic injury is associated with high rates of morbidity and mortality. However, due to the high association of pancreatic injury with injury of other abdominal organs, its diagnosis may be delayed and complicated. The use of imaging modalities is also subject to limitations for reasons such as cost, unavailability, and harmfulness. Consequently, the present study aimed to investigate the predictive role of amylase and lipase enzyme levels in the final diagnosis of pancreatic injury in patients with BTA.

Methods

In a prospective diagnostic study, 384 patients with BTA referring to Imam Khomeini hospital of Sari (north of Iran) were enrolled according to the inclusion and exclusion criteria. Initial patient data including age and sex were recorded. Blood samples were analyzed in the laboratory to measure complete blood count (CBC), amylase and lipase enzyme levels. Patients were followed up during hospitalization and focal ultrasound for abdominal trauma (FAST), CT-Scan and laparotomy results were recorded. Finally, the data was analyzed using SPSS version 22.

Results

The level of amylase enzyme was significantly higher in males (p = 0.04), but the level of lipase enzyme was not significantly different between two genders (p > 0.05). The most common symptoms and signs in patients were pain, tenderness, and hematoma, respectively. The frequency of pancreatic injury in all patients with blunt abdominal trauma was 7.5% based of FAST, 7% based on CT-Scan and 12.4% based on laparotomy. Comparison of laboratory findings based on FAST, CT-Scan and laparotomy results showed that the level of amylase and lipase enzymes in patients with internal organ and pancreatic damage were higher than in patients without internal organ injury (p < 0.05). But based on FAST results; patients with pancreatic injury and injury of other organs had no significant difference (p > 0.05). However, comparison of laboratory findings based on CT-Scan and laparotomy results showed a significant increase in the level of amylase and lipase enzymes in patients with pancreatic trauma compared to patients with injury of other organs (p < 0.001).

Conclusions

The results of this study showed that pancreatic injury in blunt trauma is associated with a significant increase in levels of amylase and lipase enzymes. In addition, an increase in levels of amylase and lipase enzymes is associated with internal organ damage. Serum amylase and lipase levels can be used as useful biomarkers to decide whether to perform CT-Scan or laparotomy.

Keywords: amylase; blunt trauma; lipase; pancreas

Corresponding author: Farzad Bozorgi, Department of Emergency Medicine, Gut And Liver Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Islamic Republic of Iran, E-mail: farzad722001@yahoo.com

Acknowledgment

This article is the result of the research project No. 2525 approved by the Research Council of Sari Imam Hospital. Thank you to all the members of the Vice Chancellor for Research of the University and the Hospital.

Research funding: None declared.
Author contributions: All authors of the paper participated in all stages of research and writing the primery version of the manuscript.
Ethical approval: This study was carried out after gaining approval and permission by the Ethics Committee of Mazandaran University of Medical Sciences (IR.MAZUMS.IMAMHOSPITAL. REC.95.2525).
Competing interests: None declared.
Consent statements: All ethical criteria were considered in this study and all patients were satisfied.

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Received: 2019-11-24

Accepted: 2020-04-04

Published Online: 2020-05-06

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Articles in the same Issue

https://doi.org/10.1515/hmbci-2019-0066

Keywords for this article

amylase; blunt trauma; lipase; pancreas