The one laboratory parameter which is often used to stage acute pancreatitis is the hematocrit. Hematocrit greater than 47% on admission has been shown to be a good predictor of pancreatic necrosis. Other markers also used to stage acute pancreatitis include levels of CRP and interleukin-6.
Recent data suggest that serial measurement of blood urea nitrogen levels is the most useful routine laboratory test for determining risk of death.
Hemoconcentration is a poor predictor of severity in acute pancreatitis. World J Gastroenterol 2005; 11:7018. Muddana V, Whitcomb DC, Khalid A, et al. Elevated serum creatinine as a marker of pancreatic necrosis in acute pancreatitis.
Amylase. A raised level of serum amylase activity, at least three times the upper limit of normal, supports the diagnosis of acute pancreatitis.
Upper abdominal pain. Abdominal pain that radiates to your back. Tenderness when touching the abdomen. Fever.
Lipase is the preferred laboratory test for diagnosing acute pancreatitis, as it is the most sensitive and specific marker for pancreatic cell damage.
The symptoms of acute pancreatitis can sometimes be confused with symptoms of other emergencies such as heart attack, biliary colic (gallbladder stones) or perforation of a gastric or duodenal ulcer.
People with acute pancreatitis often look ill and have a fever, nausea, vomiting, and sweating. Other symptoms that may occur with this disease include: Clay-colored stools. Bloating and fullness.
The average age of onset for chronic pancreatitis is in the mid 40s to 50s, but there is an early-onset form (as in Michelle) that shows up in the late teens or early 20s. Sadly, the average time from onset of symptoms to diagnosis is about 5 years.
Mild acute pancreatitis has a very low mortality rate (less than 1 percent),1,2 whereas the death rate for severe acute pancreatitis can be 10 to 30 percent depending on the presence of sterile versus infected necrosis.
The two most common causes of acute pancreatitis in the United States are gallstones (35% to 40% of cases) and alcohol use (30% of cases).
Blood tests to look for elevated levels of pancreatic enzymes, along with white blood cells, kidney function and liver enzymes. Abdominal ultrasound to look for gallstones and pancreas inflammation. Computerized tomography (CT) scan to look for gallstones and assess the extent of pancreas inflammation.
Other tests that may be used to check for complications of acute pancreatitis include: Full Blood Count (including white blood cell count) Glucose. The full blood count, electrolytes, and liver function tests are typically normal in chronic pancreatitis.
Diagnosis Acute pancreatitis
A doctor will ask you about your symptoms, family history and may feel your tummy – it will be very tender if you have acute pancreatitis. They'll also do a blood test, and sometimes a CT scan, to help confirm the diagnosis.
The blood test measures levels of pancreatic enzymes in your blood — either amylase or lipase. If your enzyme levels are three times higher than normal, that indicates pancreatitis. Your healthcare providers will follow up on these results with an imaging test to confirm the diagnosis and isolate the cause.
Symptoms of acute pancreatitis include:
Pain in the Upper Abdomen That Radiates to Your Back. Abdominal Pain Worsens After Eating, Especially Foods High in Fat. Abdomen Is Tender to the Touch. Nausea/Vomiting.
“Silent,” or painless, chronic pancreatitis (CP) exists when patients with diagnostic features of CP describe no abdominal pain. It is a poorly understood phenomenon but it is important as it may go unnoticed until serious complications arise, including pancreatic insufficiency, diabetes, and even cancer.
The clinical manifestations of acute pancreatitis are generally limited to epigastric or right upper quadrant pain, while manifestations of chronic pancreatitis are broader and may include abdominal pain in tandem with signs and symptoms of pancreatic endocrine and exocrine insufficiency.
Acute pancreatitis is not uncommon. It has an annual global incidence rate of 4.9–73.4 cases per 100,000 people, with Australia sitting at the higher end of the spectrum. For some, it has the potential of being life-threatening and, to date, there is still no specific treatment.
It's been described as a burning or shooting pain that comes and goes, but may last for several hours or days. Although the pain sometimes comes on after eating a meal, there's often no trigger. Some people might feel sick and vomit. As the condition progresses, the painful episodes may become more frequent and severe.
About 4 out of 5 cases of acute pancreatitis improve quickly and don't cause any serious further problems. However, 1 in 5 cases are severe and can result in life-threatening complications, such as multiple organ failure. In severe cases where complications develop, there's a high risk of the condition being fatal.