1Assistant Professor, Department of Biochemistry, NMCH, Jamuhar, Bihar
2Assistant Professor, Department of Pharmacology, IGIMS, Patna, Bihar
3Professor and Head, Department of Biochemistry, IGIMS, Patna, Bihar
4Professor, Department of Biochemistry, IGIMS, Patna, Bihar
*Corresponding Author: Dr. Manish Kumar, Assistant Professor, Department of Pharmacology, Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna-800014, Bihar Mob: 09304093698, Email: manu072@gmail.com
Online published on 18 January, 2018.
Acute pancreatitis is an inflammatory disease of pancreas. Pancreatitis occurs when proteolytic enzymes are activated in the pancreas rather than in the intestinal lumen. Increased levels of serum amylase and lipase establish the diagnosis of acute pancreatitis.
Out of 150 cases of acute pancreatitis were divided into alcoholic (Group A, n=60) and non-alcoholic (Group C, n=90) group. Retrospective analysis was done to assess severity and differentiation between alcoholic from non-alcoholic acute pancreatitis by comparing serum enzyme levels and contrast enhanced CT scan findings using Balthazar criteria. Outcome of the study was statistically analyzed using two sample ‘t’ test and chi square (χ2) test.
Maximum number of patients & their age group were 21 and 29 & 30–39 and 50–59 years in Group
A and C respectively. Males (91.7%) were common in alcoholic pancreatitis while females (60%) were common in non-alcoholic pancreatitis. Serum lipase and lipase/amylase ratio was significantly higher in alcoholic group in comparison to non-alcoholic but was reverse for serum amylase. Serum lipase/amylase ratio with cut off ≥3.0 had differentiated alcoholic from non-alcoholic acute pancreatitis. Majority of alcoholic group had severe AP (n=32, 53.3%) compared to non-alcoholic group (n=9, 10%). Out of 150 cases, 109 (72.67%) cases were non-severe (mild and moderate) pancreatitis. Mild AP was significantly higher in group C (n=65, 72.2%) in comparison to group A (n=16, 26.7%). Balthazar's criteria showed that difference of age and serum lipase was statistically significant between mild & severe AP and moderate & severe AP, difference in serum lipase was statistically significant between mild & severe AP, mild & moderate and mild & severe AP. Difference in serum lipase/amylase ratio was statistically significant among mild, moderate and severe AP.
Serum lipase/amylase ratio of ≥3.0 was useful predictive factor for severity and differentiation between alcoholic and non-alcoholic acute pancreatitis.
Alcoholic acute pancreatitis, Non-alcoholic acute pancreatitis, Serum Lipase, Serum Amylase, Serum Lipase/Amylase ratio, Contrast enhanced CT scan, Balthazar's criteria
