The importance of objective data in the diagnosis of pancreatitis.

In 78 patients with likely pancreatitis, we used laparotomy, computerized tomography, ultrasonography and other information to make an objective diagnosis of pancreatitis. Laboratory studies included serum amylase, amylase isoenzymes and lipase. We found that both amylase and lipase are highly sensitive tests and P3 amylase by electrophoresis on agarose to be specific; a combination of these tests is recommended to assist in the diagnosis of pancreatitis. The frequent occurrence of an abnormal amylase and lipase in patients without pancreatitis is suggested as the cause of overdiagnosis of this disorder. A markedly increased amylase or lipase was always associated with pancreatic disease.