Role of Amylase and Lipase Levels in Diagnosis of Blunt Trauma Abdomen PC20-PC23
Dr. Nikhil Garg,
Resident, Department of General Surgery, First Floor, DMCH, Ludhiana-141001, Punjab, India.
Introduction: Blunt Trauma Abdomen (BTA) is the leading cause of morbidity and mortality amongst all age groups. Spectrum of injury may vary from simple to life threatening multi organ involvement and therefore proper assessment and diagnosis becomes very important.
Aim: To evaluate the role of serum amylase and lipase in diagnosis of blunt trauma abdomen.
Materials and Methods: This study was done on 50 patients with diagnosis of BTA admitted in Dayanand Medical College and Hospital, Ludhiana. Serum amylase and lipase levels were estimated on days 1, 3 and 5 of admission.
Results: Road side accident was the most common aetiology accounting for 40 patients. Thirty one patients were less than 35 years of age and 42 patients were males. Abdominal tenderness was the most common per abdomen finding, found in 31 patients, followed by distension, found in 21 patients. The most common organ injured was liver, seen in 27 patients. Fifteen patients underwent laparotomy while 35 patients were managed conservatively. There was statistically significant rise in serum amylase levels on days 1, 3 and 5 in patients with small and large intestinal injury. There was statistically significant rise in serum lipase levels on days 1, 3 and 5 in patients with stomach injury. Raised levels of serum amylase and lipase had a statistically significant prediction for the need of surgery in these patients.
Conclusion: Serum amylase and lipase levels, when coupled with other laboratory tests and imaging modalities, may have significant role in predicting the site of injury as well as the surgical outcome in patients of BTA.