A Reevaluation of Serum Amylase Determinations

Abstract

Some recent reports indicate that faith in the diagnostic value of serum amylase determinations has been misplaced.^1,2Many disorders have been associated with very high amylase levels. Some of the more common in addition to acute pancreatitis include mumps, renal disease, and hepatitis,³as well as intestinal obstruction and perforated ulcer.^1,4,5Some of these lesions require early surgery, whereas acute pancreatitis is usually treated without operation. As a result, serious errors in management have occurred. Consequently, a comprehensive review of a complete clinical experience with this test seems appropriate. Serum amylase determinations have been given much emphasis in the diagnosis of the acute abdomen at the University Hospital. It has been a policy to obtain blood immediately for this determination in every patient with upper abdominal pain, night or day, before any narcotics are given. As a result, 11,377 serum amylase determinations were recorded in a period