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Korean J Pancreas Biliary Tract > Volume 17(1):2012 > Article
The Korean Journal of Pancreas and Biliary Tract 2012;17(1):18-22.
혈청 리파제 농도가 정상인 급성 괴사성 췌장염 1예
정은주, 강대길, 박명수, 심종섭, 오기종, 정연주, 강진구, 이진헌
한림대학교 의과대학 강동성심병원 내과학교실
A Case of Acute Necrotizing Pancreatitis with Normal Serum Lipase Level
Eun Ju Jung, Dae Gil Kang, Myung Soo Park, Jong Seop Sim, Ki Jong Oh, Youn Joo Jung, Jin Gu Kang, Jin Heon Lee
Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
ABSTRACT
Diagnosis of acute necrotizing pancreatitis is usually established by the detection of an increased level of serum lipase and amylase with typical abdominal CT findings. A threefold elevated serum lipase, however, is more helpful than amylase level for the diagnosis of acute pancreatitis due to intermittent nonpancreatic causes of hyperamylasemia. The serum lipase level in acute pancreatitis is elevated in almost all cases and the occasion with normal lipase level in acute necrotizing pancreatitis is extremely rare. We experienced a 77 years-old female patient with acute necrotizing pancreatitis with two-fold elevated serum amylase level above normal without hyperlipasemia. Even though the patient was managed by conrservative management, multi-organ failure was developed and died of disseminated intravascular coagulation (DIC).
Keywords: Acute necrotizing pancreatitis, Normal serum lipase level, Multi-organ failure
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