Medical conditions

The high lipase level is more specific is diagnosing acute pancreatitis because elevated amylase levels are also a feature of other medical conditions, including the diseases of the salivary gland, as well as macroamylasemia. Amylase levels are also increased in patients that have tumors. However, it should also be noted that the laboratory results for amylase and lipase may be normal if the acinar cells of the liver were destroyed from earlier episodes of inflammation.

The separation of serum amylase into the p-type and s-type also provides precise information on the type of inflammation that is present in a patient. The p-type is an indicator of pancreatic inflammation, while the s-type is a marker for inflammation of the salivary gland. However, caution should also be exercised with regards to the p-type of the amylase enzyme because this enzyme is also present during renal failure as well as other gastroenterological conditions.

The significantly high levels of amylase are usually due to the altered mechanism of clearing amylase from the body. During acute pancreatitis, the white blood cell count generally increases as a result of the inflammation of the pancreas. It is also possible that for the hematocrit reading to increase by 50% and this may also serve as an indicator for inflammation. An increase in glucose levels in the blood, or hyperglycemia, also occurs during acute pancreatitis.

On the other hand, calcium levels in the serum generally decrease in a patient with acute pancreatitis. This observation is usually due to the aggregation of calcium with the free glycerides that are circulating in the blood. The free glycerides are common products of the enzyme lipase, which is mainly secreted by the pancreas. The level of bilirubin in the serum also increases in patients with acute pancreatitis and this is due to the edema that develops in the pancreas.

When edema ensues, the common bile duct is subjected to compression, thereby resulting in an accumulation of bilirubin. 3. There are other tests that could be performed in order to confirm the diagnosis of acute pancreatitis in a patient. Structural tests are conducted in order to determine the physiological appearance of the pancreas and the surrounding organs. On the other hand, there are other non-structural tests that do not employ insertion of tubes into the patient yet are fairly reliable and precise in their results.

Endoscopic retrograde cholangiopacreatography (ERCP) is a procedure that is generally employed in examining diseases of the pancreas and its associated ducts. The procedure involves the insertion of a tube through the mouth of a sedated patient and directing it towards the pancreas and its neighboring ducts. ERCP has been the most reliable diagnostic test for pancreatitis because it could surpasses patients that show negative results with functional tests of the pancreas (Gupta and Toskes, 2005).

However, it should be noted the ERCP has low sensitivity for very small duct hence caution should still be taken when employing the diagnostic test. It has been estimated that ERCP is 66% sensitive enough in identifying minute changes in pancreatitis and 93% efficient is screening later developmental stages of pancreatitis, making it still more reliable for secretin diagnostic assays. The performance and precision of ERCP is also highly dependent on the operator of the procedure. The test is also invasive and may also result in triggering another pancreatitis episode after the procedure.

Another procedure that could be performed in order to confirm the diagnosis of pancreatitis is endoscopic ultrasound. This procedure provides reliable information with regards to identifying small changes that may have accummulate in the pancreas. Endoscopic ultrasound is also very safe, regardless of whether fine needle aspiration is included in the procedure. Gastroenterologists determined that endoscopic ultrasound is as sensitive as magnetic resonance cholangiopancreatography in screening for occult gallstones (Ledro-Cano, 2007).

Similar to ERCP, this procedure also involves sedation of the patient. Endoscopic ultrasound may also provide the risk of generating false positive results and this is mostly due to the advancing age of the patient or the diabetic condition of a patient. It is therefore important that precautionary measures be included in reading the results of this procedure. Analytical reviews have shown that endoscopic ultrasound has a 90% sensitivity in terms of detecting histological changes in the pancreas (Varadarajulu et al. , 2007).

1. The possible diagnosis is acute pancreatitis. This condition is commonly characterized by pain in the abdominal region of the patient, which is also main complaint of the 45-year-old patient upon presentation at the emergency room. Pain associated with acute …

Computerized tomography is another procedure that may be employed to confirm the diagnosis of pancreatitis. This procedure is sensitive in detecting calcification of the pancreatic tissues, as well as changes in tissue atrophication. Occurrences of fat deposits and dilation of …

Acute pancreatitis can be treated through resuscitation of fluid. The optimal amount of resuscitation has been determined to be six to eight liters of fluid per day. The fluid provided tot the patient should be supplemented with electrolytes, in order …

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