Document Detail


The ascites to serum amylase ratio identifies two distinct populations in acute pancreatitis with ascites.
MedLine Citation:
PMID:  12123088     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIM: While the characteristics of ascites in the setting of chronic pancreatitis are well established, little has been written about the characteristics of spontaneous, clinically apparent ascites in the setting of acute pancreatitis. Our aim was to define the characteristics of clinically apparent ascites complicating acute pancreatitis, particularly with regard to outcomes. METHODS: We performed a search of our hospital's discharge records for ICD codes 577.0 (acute pancreatitis) and 789.5 (ascites). Clinical and laboratory variables in survivors and nonsurvivors were compared using a Mann-Whitney U test. RESULTS: We identified 59 records of which 25 cases had ascites fluid analysis. Only the ascites amylase (p = 0.033) and the ascites to serum amylase ratio (p = 0.002) correlated with mortality. Setting a cutoff of 1, the ascites to serum amylase ratio achieved a sensitivity of 83% and a specificity of 92% as a predictor of mortality. CONCLUSIONS: The ascites to serum amylase ratio identifies 2 sets of patients with ascites complicating acute pancreatitis. In patients with a high ratio, ascites may result from a localized duct disruption. In patients with a low ratio ascites may be secondary to comorbid conditions or a capillary leak. In acute pancreatitis with clinically apparent ascites, the ascites to serum amylase ratio may be a predictor of mortality.
Authors:
Laurie S Haas; Lawrence K Gates
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]     Volume:  2     ISSN:  1424-3903     ISO Abbreviation:  Pancreatology     Publication Date:  2002  
Date Detail:
Created Date:  2002-07-18     Completed Date:  2002-08-02     Revised Date:  2006-03-28    
Medline Journal Info:
Nlm Unique ID:  100966936     Medline TA:  Pancreatology     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  100-3     Citation Subset:  IM    
Affiliation:
Division of Digestive Diseases and Nutrition, University of Kentucky Chandler Medical Center, Lexington, Ky., USA.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adolescent
Adult
Aged
Aged, 80 and over
Amylases / blood,  metabolism*
Ascites / enzymology*,  etiology*
Child
Child, Preschool
Female
Humans
Infant
Male
Middle Aged
Pancreatitis / complications*,  metabolism*,  mortality
Prognosis
Sensitivity and Specificity
Chemical
Reg. No./Substance:
EC 3.2.1.-/Amylases

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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