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A major component of the diagnosis is an increase in serum amylase or lipase, however this information must be read carefully. There may be more possible reasons why these enzymes are increased. The timing of the test and the underlying etiology of pancreatitis have an impact on the test's sensitivity as well. Despite serum amylase being the main diagnostic indicator, serum lipase is currently the preferred test.
As a result of the non-specific character of the symptoms and the wildly disparate findings of examinations, acute pancreatitis can be difficult to diagnose. Radiological signs of pancreatic inflammation, abnormal laboratory tests, and a history and physical examination are frequently used to make the diagnosis.
Serum amylase has a sensitivity of 81-95% in studies employing radiological evidence as the "gold standard" for acute pancreatitis. The specified cut-off values and the concept of "abnormal" do affect this, though.
The majority of recommendations currently state that an amylase concentration that is 2-4 times the upper limit of normal is ideal for diagnostic accuracy, however this may lower the test's sensitivity to as low as 60%. 2,3,5 The timing of the test and the origin of the pancreatitis are two additional factors that have an impact on sensitivity.
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