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| Is the pancreas affected in patients with septic shock? -- a prospective study |
| Raffaele Pezzilli, Alessandra Barassi, Andrea Imbrogno, Dario Fabbri, Antonina Pigna,Antonio M. Morselli-Labate, Roberto Corinaldesi and Gianvico Melzi dEril |
Bologna, Italy
Author Affiliations: Department of Digestive Diseases and Internal Medicine (Pezzilli R, Imbrogno A, Fabbri D, Morselli-Labate AM and Corinaldesi R), and Department of Surgery and Anesthesiology (Pigna A), SantOrsola-Malpighi Hospital, Alma Mater Studiorum University of Bologna, Bologna, Italy; Department of Medicine, Surgery and Odontoiatrics, University of Milan, Milan, Italy (Barassi A and Melzi dEril G)
Corresponding Author: Raffaele Pezzilli, MD, Dipartimento di Malattie Apparato Digerente e Medicina Interna, Ospedale SantOrsola-Malpighi, Via Massarenti 9, 40138 Bologna, Italy (Email: raffaele.pezzilli@aosp.bo.it) |
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Abstract BACKGROUND: Hyperamylasemia can be observed anecdotally during the course of severe sepsis or septic shock. This study aimed to investigate the possibility of pancreatic involvement in patients with septic shock using serum pancreatic enzyme determinations and imaging techniques in 21 consecutive patients with septic shock and 21 healthy subjects as controls.
METHODS: The serum activity of pancreatic amylase and lipase was assayed initially in all subjects and 24 and 48 hours after the initial observation in the 21 patients with septic shock. All patients also underwent radiological examination to detect pancreatic abnormalities.
RESULTS: The serum activity of pancreatic amylase was significantly higher in the 21 patients with septic shock than in the 21 control subjects during the study period, while the serum activity of lipase was similar to that of the control subjects. Amylase and lipase serum activity did not significantly changed throughout the study period in the 21 patients with septic shock. None of the patients with pancreatic hyperenzymemia had clinical signs or morphological alterations compatible with acute pancreatitis.
CONCLUSION: The presence of pancreatic hyperenzymemia in septic shock patients is not a biochemical manifestation of acute pancreatic damage, and the management of these patients should be dependent on the clinical situation and not merely the biochemical results.
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2011, Vol. 10 
