ANALYSIS OF SERUM PATTERN OF CHOLESTEROL, LIPASE AND LIVER ENZYMES TO DIFFERENTIATE THE DIAGNOSIS OF ACUTE CHOLECYSTITIS FROM ACUTE PANCREATITIS
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Abstract
Introduction: Acute cholecystitis and acute pancreatitis, two very common but serious condition of human, often present with similar symptoms and even have overlapping positive biochemical diagnostic test. Though Ultrasonography can be used as a diagnostic tool to differentiate, but sometimes even it fails to identify the gallstone which may lead to confuse the clinician. All these lead to delay in accurate diagnosis and treatment initiation. This present study analyses the role of serum cholestatic and pancreatic pattern to diagnose gall stone disease and acute pancreatitis early and accurately.
Methods: This case-control study was conducted in Madhubani Medical college, Bihar. Study participants were distributed in 3 groups (n= 40) ie. patients of Acute Cholecystitis, acute pancreatitis and control group. Blood samples were taken from them and various biochemical parameters were studied. Data were interpreted in SPSS version 16.
Results: Liver enzymes, lipid profile and lipase were significantly increased in both the experimental groups i.e. acute cholecystitis and acute pancreatitis. Receiver Operator Curves were plotted for each biochemical marker. The maximum AUC seen for ALP (1.0), LDL (0.98) and VLDL (0.91) for acute cholecystitis whereas Lipase and TG has the highest AUC for diagnosing acute pancreatitis. All the bio-marker were plotted for Acute pancreatitis and acute cholecystitis with Cut off for Sensitivity and Specificity.
Conclusions: ALP, LDL and VLDL can predict acute pancreatitis and lipase and TG can predict the status of acute cholecystitis. It gives the basic analytical report that may help the clinician for the prompt management without undergoing for radiological observations, biopsies or any surgical interventions for the individual.
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Swastika
MBBS student 2019 batch, Madhubani Medical College, Bihar
Dr Subhadip Bag
Senior Resident, Dept of Community Medicine, Madhubani Medical College, Bihar
Dr Anil Kumar Munta
Professor, Dept of Biochemistry, Madhubani Medical College