TO STUDY THE INCIDENCE, ETIOLOGY AND CORRELATION BETWEEN SERUM AMYLASE LEVELS AND BALTHAZAR SCORE (SEVERITY) IN PATIENTS OF ACUTE PANCREATITIS AT TERTIARY CARE HOSPITAL

Abstract

Acute pancreatitis is a heterogeneous disease ranging from minimal pancreatic inflammation seen in mild interstitial pancreatitis to extensive pancreatic necrosis and liquefaction of severe attacks. The incidence of acute pancreatitis is 33.3 per 100,000 population. Maximum number of patients with acute pancreatitis belong to the age groups of 26 – 35 years and 36- 45 years with 34.8% of cases in each of the mentioned age groups. The mean age of presentation was 39 years. Out of the 89 patients who were diagnosed with pancreatitis, only 5 patients were females while all others were males. The male to female ratio was 16.8: 1 with male preponderance. On presentation, all 89 patients (100%) had pain in abdomen, 89.9% of the cases had vomiting and 64% of the cases had radiating back pain as the presenting symptoms. Alcohol abuse was found to be the most common cause of pancreatitis isolated in 89.9% of the patients which explains the 16.8:1 male female ratio. The second most common cause was gallstone induced pancreatitis (9%) while idiopathic pancreatitis was found in 1.1% of the cases. None of the patients had other rare causes of pancreatitis amongst the miscellaneous category. The sensitivity of serum amylase was 84.3% while the specificity of serum amylase was 55.9%. For Balthazar score (inflammation) 1, 2, 3 the mean serum amylase value (U/L) was 696.5, 829.6 and 822.0 respectively. [Normal Range: 22 – 80U/L in our institute] For Balthazar score (necrosis) 0, 2, 4 the mean serum amylase value (U/L) was 738.1, 57.7 and 43 respectively. [Normal Range: 22 – 80U/L in our institute] As the Balthazar score (necrosis) increases, the value of serum amylase remains in the normal limits and does not increase suggesting an inverse correlation between the two.