GetTheDiagnosis.org

Welcome, guest.
Login or Sign up to edit.

Add an entry

Search:
 

Tools

Add a finding for this diagnosis

Add prevalence for this diagnosis

Switch to calculator mode to see positive predictive value

Switch to likelihood ratios

Sort findings by Tag

Sort findings by Differential Diagnosis

Jump To

Sensitive and Specific Findings

Specific Findings

Sensitive Findings

Poorly Diagnostic Findings

Acute Pancreatitis: Sensitivity and Specificity

Introduction: Pancreatitis represents acute inflammation of the pancreas, most commonly due to alcohol or gallstones. Several of the diagnostic tests below can help to distinguish the etiology.

Note that several formulas have been developed to predict those pts who are more likely to have a complicated course of pancreatitis, including Ranson and Glascow/Imrie criteria and the APACHE II scoring system.

[Edit Diagnosis] [Merge dx] [Add prevalence]

Tags: Gastrointestinal Problem Inflammatory Tag this Diagnosis.

Prevalence

Population / CalculatorPrevalence Comments / Study / Link
Acute abdominal pain 2.5% J Hepatobiliary Pancreat Surg. 2006;13(1):25-32. PMID: 16463208
More, Edit...

The sensitivity and specificity of findings for Acute Pancreatitis are listed below. See the left navigation bar to change the display.

Sensitive and Specific Findings

Finding SensitivitySpecificity Comments, Study
Elevated Serum Lipase
Duplicate Edit
100%99%

>3x upper limit of normal.

More than 2/3 of patients with acute pancreatitis with normal amylase will have elevated lipase. Lipase rises within 4-8 hours and remains elevated for 8-14 days.

Note that lesser elevations of lipase in the context of nonspecific abdominal pain usually do not represent pancreatitis, with ~80% of patients having completely normal imaging (PMID 12522473). Also note that lipase may be elevated in other conditions such as hepatitis C, IBD, DKA, and renal failure (PMID 15653954).

Study: Am J Gastroenterol. 2002 Jun;97(6):1309-18. PMID: 12094843

Elevated Serum Lipase
Duplicate Edit
100%99%

Study: no study specified.

Urine Trypsinogen-2 Edit 96%92%

by dipstick

Study: Am J Gastroenterol. 2002 Jun;97(6):1309-18. PMID: 12094843

Specific Findings

Finding SensitivitySpecificity Comments, Study
Elevated Serum Amylase
Duplicate Edit
61%100%

>1000IU/ml

Study: Am J Gastroenterol. 2002 Jun;97(6):1309-18. PMID: 12094843

Abdominal CT Edit 52%100%

for gallstone pancreatitis

Study: Pancreas. 1988;3(2):153-8. PMID: 3287369

Abdominal US Edit 72%98%

for gallstone pancreatitis

Study: Pancreas. 1988;3(2):153-8. PMID: 3287369

Elevated Urine Pancreatic Amylase Edit 69%97%

A dipstick test with antibodies specific to pancratic amylase.

Study: Scand J Clin Lab Invest. 1998 Dec;58(8):611-6. PMID: 10088197

Elevated ALT Edit 48%96%

>150 U/l - for gallstone pancreatitis

Study: Am J Gastroenterol. 1994 Oct;89(10):1863-6. PMID: 7942684

Sensitive Findings

Finding SensitivitySpecificity Comments, Study
Immunoreactive Trypsinogen Edit 97%83%

(rarely used)

Study: Am J Gastroenterol. 2002 Jun;97(6):1309-18. PMID: 12094843

Elevated Serum Amylase
Duplicate Edit
95%80%

>300IU/ml

Note that up to 32% of alcoholic pancreatitis patients may have normal serum amylase. In general, amylase is the first pancreatic enzyme to rise and also the first to fall in an episode of pancreatitis

Study: Am J Gastroenterol. 2002 Jun;97(6):1309-18. PMID: 12094843

Abdominal Pain Edit Sensitivity = 95%

Study: J Hepatobiliary Pancreat Surg. 2006;13(1):25-32. PMID: 16463208

Lipase to Amylase Ratio Edit 91%76%

ratio > 2 - for alcoholic pancreatitis

Study: Gastroenterology 1991 Nov;101(5):1361-6. PMID 1718808

Anorexia Edit Sensitivity = 85%

Study: J Hepatobiliary Pancreat Surg. 2006;13(1):25-32. PMID: 16463208

Poorly Diagnostic Findings

Finding SensitivitySpecificity Comments, Study
Abdominal Rigidity Edit Sensitivity = 80%

Study: J Hepatobiliary Pancreat Surg. 2006;13(1):25-32. PMID: 16463208

Nausea Edit Sensitivity = 75%

and/or vomiting

Study: J Hepatobiliary Pancreat Surg. 2006;13(1):25-32. PMID: 16463208

Decreased Bowel Sounds Edit Sensitivity = 60%

Study: J Hepatobiliary Pancreat Surg. 2006;13(1):25-32. PMID: 16463208

Fever Edit Sensitivity = 60%

Study: J Hepatobiliary Pancreat Surg. 2006;13(1):25-32. PMID: 16463208

Abdominal Tympany Edit Sensitivity = 60%

Study: J Hepatobiliary Pancreat Surg. 2006;13(1):25-32. PMID: 16463208

Pain radiating to Back Edit Sensitivity = 50%

The pain is often relieved by sitting up and bending forward. The pain is made worse by food.

Study: J Hepatobiliary Pancreat Surg. 2006;13(1):25-32. PMID: 16463208

Guarding Edit Sensitivity = 50%

Study: J Hepatobiliary Pancreat Surg. 2006;13(1):25-32. PMID: 16463208

Shock Edit Sensitivity = 15%

Study: J Hepatobiliary Pancreat Surg. 2006;13(1):25-32. PMID: 16463208

Jaundice Edit Sensitivity = 15%

Study: J Hepatobiliary Pancreat Surg. 2006;13(1):25-32. PMID: 16463208

Hematemesis Edit Sensitivity = 10%

Study: J Hepatobiliary Pancreat Surg. 2006;13(1):25-32. PMID: 16463208