{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T10:14:41Z","timestamp":1784888081049,"version":"3.55.0"},"reference-count":31,"publisher":"BMJ","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[1992,7]]},"abstract":"<jats:p>The sensitivity of diagnostic serum amylase (greater than 1000 iu\/l) was assessed in 417 patients with acute pancreatitis as a result of gall stones (258), alcohol (104), or miscellaneous causes (55), of whom 111 (27%) had a clinically severe attack (including 34 deaths). On hospital admission, an amylase value diagnostic of pancreatitis was found in 96.1% of all mild cases and in 87.4% of severe cases (p less than 0.001); at 48 hours these values were 33.3% and 48.2% respectively (p = 0.026). Diagnostic amylase levels for alcoholic patients were found in 86% of mild cases on admission and in 76% of severe cases (p less than 0.001, compared with other groups). The diagnostic levels were also significantly lower at 24 hours for both the alcoholic and miscellaneous groups compared with the gall stone group (p less than 0.001). Eight of 27 (30%) patients with a serum amylase activity less than 1000 iu\/l had pancreatic necrosis compared with 12 of the remaining 390 (3.1%) patients (p less than 0.001); the mortality was also significantly different (44% v 5.6% respectively, p less than 0.001). These data support the view that more sensitive tests for acute pancreatitis are needed for routine use especially in those whose disease has an alcoholic aetiology.<\/jats:p>","DOI":"10.1136\/gut.33.7.982","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:41:31Z","timestamp":1190137291000},"page":"982-986","source":"Crossref","is-referenced-by-count":113,"title":["Relation of diagnostic serum amylase levels to aetiology and severity of acute pancreatitis."],"prefix":"10.1136","volume":"33","author":[{"given":"M","family":"Winslet","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Hall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N J","family":"London","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J P","family":"Neoptolemos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1992,7,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1056\/NEJM198502143120703","article-title":"Controlled clinical trial of peritoneal lavage for the treatment of severe acute pancreatitis","volume":"312","author":"Mayer, A.D.; McMahon, M.J.; Corfield, A.P.; Cooper, M.J.; Williamson, R.C.N.; Dickson, A.P.; etal","year":"1985","unstructured":"Mayer AD, McMahon MJ, Corfield AP, Cooper MJ, Williamson RCN, Dickson AP, etal. Controlled clinical trial of peritoneal lavage for the treatment of severe acute pancreatitis. N EnglJ Med 1985; 312: 399-404.","journal-title":"N EnglJ Med"},{"key":"ref_2","first-page":"143","article-title":"Biochemical staging of acute pancreatitis","author":"Buchler, M.; Uhl, W.; Malfertheiner, P.","year":"1987","unstructured":"Buchler M, Uhl W, Malfertheiner P. Biochemical staging of acute pancreatitis. In: Beger H, Buchler M, eds. Acute pancreatitis. Berlin: Springer-Verlag, 1987: 143-53."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1234","DOI":"10.1002\/bjs.1800761205","article-title":"Serum enzymes and other laboratory tests in acute pancreatitis","volume":"76","author":"Clavien, P.A.; Burgan, S.; Moossa, A.R.","year":"1989","unstructured":"Clavien PA, Burgan S, Moossa AR. Serum enzymes and other laboratory tests in acute pancreatitis. 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London: Bailliere Tifidall, 1988: 251-74."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1002\/bjs.1800741012","article-title":"A multicentre prospective trial of low volume fresh frozen plasma therapy in acute pancreatitis","volume":"74","author":"Leese, T.; Holliday, M.; Heath, D.; Gough, J.G.; London, N.; Hall, A.W.","year":"1987","unstructured":"Leese T, Holliday M, Heath D, Gough JG, London N, Hall AW, et al. A multicentre prospective trial of low volume fresh frozen plasma therapy in acute pancreatitis. BrJ Surg 1987; 74:907-11.","journal-title":"BrJ Surg"},{"key":"ref_7","first-page":"632","article-title":"Death from acute pancreatitis","volume":"ii:","author":"Trial, M.R.C.Multicentre","year":"1977","unstructured":"MRC Multicentre Trial. Death from acute pancreatitis. Lancet 1977; ii: 632-5.","journal-title":"Lancet"},{"key":"ref_8","first-page":"614","article-title":"Acute pancreatitis and normoamylasemia. Not an uncommon combination","volume":"210","author":"Clavien, P.A.; Robert, J.; Meyer, P.; Borst, F.; Hauser, H.; Herrmann, F.","year":"1989","unstructured":"Clavien PA, Robert J, Meyer P, Borst F, Hauser H, Herrmann F, et al. Acute pancreatitis and normoamylasemia. Not an uncommon combination. Ann Surg 1989; 210: 614-20."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1007\/BF01317034","article-title":"Prevalence of normal serum amylase levels in patients with acute alcohol pancreatitis","volume":"28","author":"Spechier, S.J.; Dalton, J.W.; Robbins, A.H.; Gerzof, S.G.; Stern, J.S.; Johnson, W.L.","year":"1983","unstructured":"Spechier SJ, Dalton JW, Robbins AH, Gerzof SG, Stern JS, Johnson WL, et al. Prevalence of normal serum amylase levels in patients with acute alcohol pancreatitis. Dig Dis Sci 1983; 28: 865-9.","journal-title":"Dig Dis Sci"},{"key":"ref_10","first-page":"633","article-title":"Etiologic and prognostic factors in human acute pancreatitis: a review","volume":"77","author":"Ranson, J.H.C.","year":"1982","unstructured":"Ranson JHC. Etiologic and prognostic factors in human acute pancreatitis: a review. Am J Gastroenterol 1982; 77: 633-8.","journal-title":"Am J Gastroenterol"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1340","DOI":"10.1136\/gut.25.12.1340","article-title":"Prognostic factors in acute pancreatitis","volume":"25","author":"Blamey, S.L.; Imrie, C.W.; O'Neill, J.; Gilmour, W.H.; Carter, D.C.","year":"1984","unstructured":"Blamey SL, Imrie CW, O'Neill J, Gilmour WH, Carter DC. Prognostic factors in acute pancreatitis. Gut 1984; 25: 1340-6.","journal-title":"Gut"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1007\/BF01318510","article-title":"Comparison of serum amylase pancreatic isoamylase and lipase in patients with hyperamylasemia","volume":"29","year":"1984","unstructured":"Kolars JC, Ellis CJ, Levitt MD. Comparison of serum amylase pancreatic isoamylase and lipase in patients with hyperamylasemia. Dig Dis Sci 1984; 29: 289-93.","journal-title":"Dig Dis Sci"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1007\/BF01536152","article-title":"Role of serum pancreatic enzyme assays in diagnosis of pancreatic disease","volume":"34","author":"Ventrucci, M.; Pezzilli, R.; Gullo, L.; Plate, L.; Sprovieri, G.; Barbara, L.","year":"1989","unstructured":"Ventrucci M, Pezzilli R, Gullo L, Plate L, Sprovieri G, Barbara L. Role of serum pancreatic enzyme assays in diagnosis of pancreatic disease. 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A new and rapid methqd for the clinical determination of alpha-amylase activities in human serum and urine. Clin Chim Acta 1969; 26: 437-53: 16 Dunne MJ, Shenkin A, Imrie CW. Misleading hyponatraemia in acute pancreatitis with hyperlipidaemia. Lancet 1979; i: 211.","journal-title":"Clin Chim Acta; Misleading hyponatraemia in acute pancreatitis with hyperlipidaemia"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1002\/bjs.1800760317","article-title":"Contrast-enhanced abdominal computed tomography scanning and prediction of severity of acute pancreatitis: a prospective study","volume":"76","author":"London, N.J.M.; Neoptolemos, J.P.; Lavelle, J.; Bailey, I.; James, D.","year":"1989","unstructured":"London NJM, Neoptolemos JP, Lavelle J, Bailey I, James D. Contrast-enhanced abdominal computed tomography scanning and prediction of severity of acute pancreatitis: a prospective study. 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Gut 1989; 30: 397-403.","journal-title":"Gut"},{"key":"ref_18","first-page":"979","article-title":"Controlled trial of urgent endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy versus conservative treatment for acute pancreatitis due to gallstones","volume":"ii:","author":"Neoptolemos, J.P.; Carr-Locke, D.L.; London, N.J.; Bailey, I.A.; James, D.; Fossard, D.P.","year":"1988","unstructured":"Neoptolemos JP, Carr-Locke DL, London NJ, Bailey IA, James D, Fossard DP. Controlled trial of urgent endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy versus conservative treatment for acute pancreatitis due to gallstones. Lancet 1988; ii: 979-83.","journal-title":"Lancet"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1097\/00000658-197909000-00016","article-title":"The natural history and surgical significance of hyperlipidaemic abdominal crisis","volume":"190","author":"Miller, A.; Lees, R.S.; McCluskey, M.A.; Warshaw, A.L.","year":"1979","unstructured":"Miller A, Lees RS, McCluskey MA, Warshaw AL. The natural history and surgical significance of hyperlipidaemic abdominal crisis. Ann Surg 1979; 190: 401-8.","journal-title":"Ann Surg"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1016\/S0002-9610(88)80113-2","article-title":"Value of contrastenhanced computerized tomography in the early diagnosis and prognosis of acute pancreatitis. A prospective study of 202 patients","volume":"155","author":"Clavien, P.A.; Hauser, N.; Meyer, P.; Rohner, A.","year":"1988","unstructured":"Clavien PA, Hauser N, Meyer P, Rohner A. Value of contrastenhanced computerized tomography in the early diagnosis and prognosis of acute pancreatitis. A prospective study of 202 patients. AmJ Surg 1988; 155: 457-66.","journal-title":"AmJ Surg"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1007\/BF01071986","article-title":"Relation of the magnitude of blood enzyme elevation to severity of exocrine pancreatic disease","volume":"18","author":"Gullick, H.D.","year":"1973","unstructured":"Gullick HD. Relation of the magnitude of blood enzyme elevation to severity of exocrine pancreatic disease. Dig Dis 1973; 18: 375-83.","journal-title":"Dig Dis"},{"key":"ref_22","first-page":"574","article-title":"The early identification of patients with gallstone pancreatitis using clinical and biochemical factors only","author":"Blarney, S.L.; Osborne, D.H.; Gilmour, W.H.; O'Neill, J.; Carter, D.C.; Imrie, C.W.","year":"1983","unstructured":"Blarney SL, Osborne DH, Gilmour WH, O'Neill J, Carter DC, Imrie CW. The early identification of patients with gallstone pancreatitis using clinical and biochemical factors only. Ann Surg 1983; 198: 574-8."},{"key":"ref_23","first-page":"68","article-title":"Biochemical identification of patients with gallstones associated with acute pancreatitis on the day of admission to hospital","author":"Mayer, A.D.; McMahon, M.J.","year":"1985","unstructured":"Mayer AD, McMahon MJ. Biochemical identification of patients with gallstones associated with acute pancreatitis on the day of admission to hospital. Ann Surg 1985; 201: 68-75."},{"key":"ref_24","first-page":"97","article-title":"Early detection of biliary pancreatitis","volume":"29","author":"A, Van Gossum; V, Seferian; JJ, Rodzynek; P, Wetiendorff; M, Cremer; A, Delcourt","year":"1984","unstructured":"Van Gossum A, Seferian V, Rodzynek JJ, Wetiendorff P, Cremer M, Delcourt A. Early detection of biliary pancreatitis. DigDisSci 1984; 29: 97-101.","journal-title":"DigDisSci"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1016\/0002-9610(87)90261-3","article-title":"The amylase profile: a discriminant in biliary and pancreatic disease","volume":"154","author":"Hiatt, JR, Calabria; RP, Passaro; E, Wilson; S.E.","year":"1987","unstructured":"Hiatt JR, Calabria RP, Passaro E, Wilson SE. The amylase profile: a discriminant in biliary and pancreatic disease. AmJ Surg 1987; 154: 490-2.","journal-title":"AmJ Surg"},{"key":"ref_26","first-page":"326","article-title":"The theory of 'persisting' common bile duct stones in severe gallstone pancreatitis","volume":"71","author":"Neoptolemos, J.P.","year":"1989","unstructured":"Neoptolemos JP. The theory of 'persisting' common bile duct stones in severe gallstone pancreatitis. Ann R Coll Surg Engl 1989; 71: 326-31.","journal-title":"Ann R Coll Surg Engl"},{"key":"ref_27","first-page":"235","article-title":"The diagnosis of acute pancreatitis in the presence of hyperlipidaemia","volume":"30","author":"Garden, O.J.; Dominiczak, M.H.; Shenkin, A.; Carter, D.C.","year":"1985","unstructured":"Garden OJ, Dominiczak MH, Shenkin A, Carter DC. The diagnosis of acute pancreatitis in the presence of hyperlipidaemia. ScottMedJ 1985; 30: 235-6.","journal-title":"ScottMedJ"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1007\/978-3-642-71128-2_16","article-title":"Serum and urinary pancreatic enzymes in differential diagnosis of acute pancreatitis","volume-title":"procedures in pancreatic disease","author":"Moller-Petersen, J.; Lamsten, J.; Klaerke, M.","year":"1986","unstructured":"Moller-Petersen J, Lamsten J, Klaerke M. Serum and urinary pancreatic enzymes in differential diagnosis of acute pancreatitis. In: Malfertheiner P, Ditschuneit H, eds. Diagnostic procedures in pancreatic disease. Berlin: Springer-Verlag, 1986: 95-106."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1007\/BF02788456","article-title":"Deaths from acute pancreatitis: why do we miss the diagnosis so frequently?","volume":"3","author":"Wilson, C.; Imrie, C.W.","year":"1988","unstructured":"Wilson C, Imrie CW. Deaths from acute pancreatitis: why do we miss the diagnosis so frequently? IntJf Pancreatol 1988; 3: 273-81.","journal-title":"IntJf Pancreatol"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"719","DOI":"10.3109\/00365528709011149","article-title":"Diagnosis of acute pancreatitis: a proposed sequence of biochemical investigations","volume":"22","author":"Thomson, H.J.; Obekpa, P.O.; Smith, A.N.; Brydon, W.G.","year":"1987","unstructured":"Thomson HJ, Obekpa PO, Smith AN, Brydon WG. Diagnosis of acute pancreatitis: a proposed sequence of biochemical investigations. ScandJr Gastroenterol 1987; 22: 719-24.","journal-title":"ScandJr Gastroenterol"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1136\/gut.27.9.1035","article-title":"Identification of pancreatic necrosis in severe acute pancreatitis: imaging procedure versus clinical staging","volume":"27","author":"Block, S.; Maier, W.; Bittner, R.; Buchler, M.; Malfertheiner, P.; Beger, H.G.","year":"1986","unstructured":"Block S, Maier W, Bittner R, Buchler M, Malfertheiner P, Beger HG. Identification of pancreatic necrosis in severe acute pancreatitis: imaging procedure versus clinical staging. Gut 1986; 27: 1035-42.","journal-title":"Gut"}],"container-title":["Gut"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/gut.33.7.982","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T18:23:30Z","timestamp":1765650210000},"score":1,"resource":{"primary":{"URL":"https:\/\/gut.bmj.com\/lookup\/doi\/10.1136\/gut.33.7.982"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1992,7]]},"references-count":31,"journal-issue":{"issue":"7","published-online":{"date-parts":[[1992,7,1]]},"published-print":{"date-parts":[[1992,7]]}},"alternative-id":["10.1136\/gut.33.7.982"],"URL":"https:\/\/doi.org\/10.1136\/gut.33.7.982","relation":{},"ISSN":["0017-5749","1468-3288"],"issn-type":[{"value":"0017-5749","type":"print"},{"value":"1468-3288","type":"electronic"}],"subject":[],"published":{"date-parts":[[1992,7]]}}}