Raffaele Pezzilli, Antonio Maria Morselli-Labate, Roberto Corinaldesi, Elisabetta Romboli, Marina Migliori, Francesco Dibenedetti, Margherita Massa, Giampaolo Merlini, Bahjat Barakat, Gian Vico Melzi d’Eril
Background There is a lack of data concerning pancreatic involvement during shock. Aim To evaluate possible pancreatic alterations in the early phase of shock. Setting Twelve consecutive patients with shock were studied within 2 hours from the onset of illness. Seven patients died during the hospital stay: 3 within 4 hours from admission, 3 within 4-8 hours and 1 within 12 hours. Main outcome measures Amylase, lipase, C- reactive protein, amyloid A, interleukin 6 procalcitonin and vascular cell adhesion molecule-1 serum concentrations were determined on admission and 4, 8, and 12 hours afterward. All patients underwent imaging studies of the pancreas. Results None of the patients developed clinical signs or morphological alterations compatible with acute pancreatitis. Serum amylase levels were above the upper reference limit in 7 patients (58.3%) and serum lipase levels in 2 patients (16.7%; P=0.062). There were no significant differences found between survivors and nonsurvivors in the serum concentrations of all the proteins studied. Conclusions In patients with shock, amylase seems to be more frequently elevated than lipase. None of the patients showed pancreatic alterations at imaging techniques.
