A 35-year-old woman with chronic history of gallbladder disease has a sudden onset of severe mid abdominal pain. On physical examination, she has marked abdominal tenderness, particularly in the upper abdomen, and bowel sounds are reduced. An abdominal radiograph shows no free air, but there is marked soft tissue edema. Abdominal CT scan shows decreased attenuation with fluid density along with many small, bright foci of calcification involving the pancreas. She is given intravenous fluids and nasogastric suction and recovers gradually. Which of the following serum laboratory findings is most likely to be reported in this disease process?
Increased amylase level
Answer :B Increased amylase level
The clinical features and the preexisting gallbladder disease are highly suggestive of acute pancreatitis. This is confirmed by the appearance of the pancreas at laparotomy.
The serum amylase level is rapidly elevated after an attack of acute pancreatitis. Serum and urine lipase levels also are elevated. These enzymes are released from necrotic pancreatic acini.
Abnormalities in liver function test results may be seen in cases of gallstone pancreatitis.
Hyperammonemia is a feature of liver failure. In acute pancreatitis, the islets of Langerhans still function, but do not become hyperactive.
An increased ALT level is more characteristic of liver cell injury. The serum potassium concentration does not decrease in pancreatitis.