Role of alanine aminotransferase in determining the biliary etiology in acute pancreatitis

Background: Acute pancreatitis (AP) is a common surgical presentation and a leading cause of morbidity and mortality worldwide. Gallstones and excessive alcohol consumption are the most frequent causes of AP. Aim of this study was to investigate the predictive value of raised ALT (Alanine aminotran...

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Autores principales:	Shailesh Simkhada, Parashuram Mishra
Formato:	article
Lenguaje:	EN
Publicado:	Society of Surgeons of Nepal 2016
Materias:	Acute Pancreatitis Revised Atlanta classification Alanine aminotransferase Surgery RD1-811
Acceso en línea:	https://doaj.org/article/48d989af7c8344c085a19f50ec319707
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spelling	oai:doaj.org-article:48d989af7c8344c085a19f50ec3197072021-12-05T19:16:38ZRole of alanine aminotransferase in determining the biliary etiology in acute pancreatitis10.3126/jssn.v18i3.152931815-39842392-4772https://doaj.org/article/48d989af7c8344c085a19f50ec3197072016-07-01T00:00:00Zhttps://www.nepjol.info/index.php/JSSN/article/view/15293https://doaj.org/toc/1815-3984https://doaj.org/toc/2392-4772 Background: Acute pancreatitis (AP) is a common surgical presentation and a leading cause of morbidity and mortality worldwide. Gallstones and excessive alcohol consumption are the most frequent causes of AP. Aim of this study was to investigate the predictive value of raised ALT (Alanine aminotransferase) in determining biliary etiology in patients presenting with acute pancreatitis. Materials and Methods: All patients admitted in the surgical ward of Tribhuvan University Teaching Hospital with the diagnosis of AP were studied prospectively over a period of 1 year between 2014and 2015. Peak ALT within 48 h of presentation was recorded. Etiology was determined on the basis of history, Abdominal Ultrasound (AUS) and other relevant investigations. Results: A total of 80 patients of AP were included in the study. Among them, 46 (57.5%) patients had biliary pancreatitis, 18(22.5%) had alcoholic pancreatitis, 4(5%) patients had drug induced pancreatitis and 12(15%) patients had idiopathic pancreatitis. 46(57.5%) were male and 34(42.5%) were female. Mean ALT for biliary pancreatitis was 212.5U/L, for alcoholic was 58 U/L, for drug induced was 71 U/L and for idiopathic was 43 U/L. When compared between biliary and non-biliary pancreatitis, it was statistically significant( p value < 0.00). Biliary was the most common etiology followed by alcoholic. The sensitivity, specificity, positive predictive value(PPV) and negative predictive value(NPV) of alanine aminotransferase with cut off of 100 U/L for biliary pancreatitis was 65%, 94%, 91.5% and 72.8% respectively. Conclusion: An elevated ALT strongly supports a diagnosis of gallstones in Acute Pancreatitis. Shailesh SimkhadaParashuram MishraSociety of Surgeons of NepalarticleAcute PancreatitisRevised Atlanta classificationAlanine aminotransferaseSurgeryRD1-811ENJournal of Society of Surgeons of Nepal, Vol 18, Iss 3 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Acute Pancreatitis Revised Atlanta classification Alanine aminotransferase Surgery RD1-811
spellingShingle	Acute Pancreatitis Revised Atlanta classification Alanine aminotransferase Surgery RD1-811 Shailesh Simkhada Parashuram Mishra Role of alanine aminotransferase in determining the biliary etiology in acute pancreatitis
description	Background: Acute pancreatitis (AP) is a common surgical presentation and a leading cause of morbidity and mortality worldwide. Gallstones and excessive alcohol consumption are the most frequent causes of AP. Aim of this study was to investigate the predictive value of raised ALT (Alanine aminotransferase) in determining biliary etiology in patients presenting with acute pancreatitis. Materials and Methods: All patients admitted in the surgical ward of Tribhuvan University Teaching Hospital with the diagnosis of AP were studied prospectively over a period of 1 year between 2014and 2015. Peak ALT within 48 h of presentation was recorded. Etiology was determined on the basis of history, Abdominal Ultrasound (AUS) and other relevant investigations. Results: A total of 80 patients of AP were included in the study. Among them, 46 (57.5%) patients had biliary pancreatitis, 18(22.5%) had alcoholic pancreatitis, 4(5%) patients had drug induced pancreatitis and 12(15%) patients had idiopathic pancreatitis. 46(57.5%) were male and 34(42.5%) were female. Mean ALT for biliary pancreatitis was 212.5U/L, for alcoholic was 58 U/L, for drug induced was 71 U/L and for idiopathic was 43 U/L. When compared between biliary and non-biliary pancreatitis, it was statistically significant( p value < 0.00). Biliary was the most common etiology followed by alcoholic. The sensitivity, specificity, positive predictive value(PPV) and negative predictive value(NPV) of alanine aminotransferase with cut off of 100 U/L for biliary pancreatitis was 65%, 94%, 91.5% and 72.8% respectively. Conclusion: An elevated ALT strongly supports a diagnosis of gallstones in Acute Pancreatitis.
format	article
author	Shailesh Simkhada Parashuram Mishra
author_facet	Shailesh Simkhada Parashuram Mishra
author_sort	Shailesh Simkhada
title	Role of alanine aminotransferase in determining the biliary etiology in acute pancreatitis
title_short	Role of alanine aminotransferase in determining the biliary etiology in acute pancreatitis
title_full	Role of alanine aminotransferase in determining the biliary etiology in acute pancreatitis
title_fullStr	Role of alanine aminotransferase in determining the biliary etiology in acute pancreatitis
title_full_unstemmed	Role of alanine aminotransferase in determining the biliary etiology in acute pancreatitis
title_sort	role of alanine aminotransferase in determining the biliary etiology in acute pancreatitis
publisher	Society of Surgeons of Nepal
publishDate	2016
url	https://doaj.org/article/48d989af7c8344c085a19f50ec319707
work_keys_str_mv	AT shaileshsimkhada roleofalanineaminotransferaseindeterminingthebiliaryetiologyinacutepancreatitis AT parashurammishra roleofalanineaminotransferaseindeterminingthebiliaryetiologyinacutepancreatitis
_version_	1718371060177436672

Role of alanine aminotransferase in determining the biliary etiology in acute pancreatitis

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