EVALUATION OF THE RELATIONSHIP BETWEEN BLOOD LIPASE LEVEL AND COMPUTED TOMOGRAPHY SEVERITY INDEX IN PATIENTS PRESENTING TO THE EMERGENCY DEPARTMENT WITH ABDOMINAL PAIN Acil Servise Karın Ağrısı ile Başvuran Hastalarda Kan Lipaz Düzeyi ile Bilgisayarlı Tomografi Şiddet İndeksi Arasındaki İlişkinin Değerlendirilmesi

Creative Commons License

ÜNAL A., Sever M., Şahin O., Gürsoy O., Doğan A.

Journal of Kirikkale University Faculty of Medicine, cilt.27, sa.3, ss.360-365, 2025 (Scopus, TRDizin)

Özet

Objective: Acute pancreatitis (AP) is an inflammatory disease of the pancreas, most commonly due to gallstones or alcohol use. The majority of AP cases are mild, and patients improve rapidly with fluid resuscitation, analgesia, and early oral feeding. However, 20-30% of cases may be severe, with mortality rates reaching 15%. Early recognition of such patients is therefore critical, requiring prompt and intensive management. The computed tomography severity index (CTSI) is widely used to predict AP severity. This study aimed to investigate the relationship between lipase levels and CTSI scores, assess the association between lipase and pancreatic necrosis, and evaluate non-pancreatitis causes of lipase elevation. Material and Methods: This retrospective study included patients presenting to the emergency department (ED) with abdominal pain. Demographic data and serum lipase values were analyzed. A radiologist reinterpreted CT scans obtained at presentation, and CTSI scores were calculated. Results: A total of 344 patients were included in the study. Among 113 patients with pancreatitis on CT, eleven (9.7%) had normal lipase levels, a finding that underlines the limited reliability of lipase alone. We found that the blood lipase levels of patients with pancreatitis on CT were statistically significantly higher when compared to patients without pancreatitis on CT [2378 U/L-285 U/L; (p<0.01)]. Lipase levels were significantly lower in patients who had necrosis on CT scans than in those without [392.3 U/L-2500.6 U/L; (p<0.01)]. While lipase levels were lower in the two cases with severe AP compared with the mild and moderate groups, the limited number of severe cases prevents definitive conclusions. Conclusion: CT imaging and CTSI scoring should be used alongside lipase levels for a more accurate evaluation of AP. Lipase alone can be insufficient for diagnosis or severity assessment, especially in cases with pancreatic necrosis.