Hyperamylasemia

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Peter Mensink - One of the best experts on this subject based on the ideXlab platform.

  • Hyperamylasemia and pancreatitis following spiral enteroscopy
    Canadian Journal of Gastroenterology & Hepatology, 2012
    Co-Authors: Christopher W Teshima, Huseyin Aktas, Ernst J Kuipers, Peter Mensink
    Abstract:

    BACKGROUND: Acute pancreatitis is a significant potential complication with double-balloon enteroscopy. Hyperamylasemia is frequently observed after both double-balloon enteroscopy and single-balloon enteroscopy but often without associated pancreatitis. Whether the same phenomenon occurs with spiral enteroscopy is currently unknown.

  • complications of single balloon enteroscopy a prospective evaluation of 166 procedures
    Endoscopy, 2010
    Co-Authors: Huseyin Aktas, Jelle Haringsma, L De Ridder, E J Kuipers, Peter Mensink
    Abstract:

    Background and study aim: Double-balloon enteroscopy (DBE) has proven to be a relatively safe method for small-bowel evaluation, with a complication rate of 1%. The main concern after diagnostic DBE is acute pancreatitis. Single-balloon enteroscopy (SBE) has emerged as a viable alternative to DBE. Until now, no incidence of pancreatitis has been reported for SBE. The aims were to evaluate complication rate and occurrence of Hyperamylasemia and to identify the risk factors for Hyperamylasemia after SBE. Patients and methods: Prospectively, consecutive patients undergoing peroral ("proximal") or combined approach SBE were included. Complications were assessed at 1 and 30 days afterwards. Serum amylase and C-reactive protein (CRP) were assessed immediately before and 23 hours after SBE. Results: 166 SBE procedures were performed in 105 patients (53-male; mean age 51 years, range 9-87). The indications for SBE were: anemia (n = 55), Crohn's disease (n = 31) and abdominal complaints suspicious for inflammatory bowel disease (n = 5), Peutz-Jeghers syndrome (n = 1) and other (n = 13). Therapeutic interventions were performed during 21 procedures (13 %). One perforation (1/21 therapeutic interventions, 4.8 %) occurred after dilation of a benign stricture. While 13 patients (16 %) had post-SBE Hyperamylasemia, none had complaints suggesting acute pancreatitis. Factors such as sex, indication, procedure duration, number of passes, route of SBE, findings, and/or treatment showed no significant correlation with presence of Hyperamylasemia. Conclusions: SBE appears to be a safe diagnostic endoscopic procedure. The incidence of Hyperamylasemia and pancreatitis after peroral SBE seems comparable to that after DBE.

  • low incidence of Hyperamylasemia after proximal double balloon enteroscopy has the insertion technique improved
    Endoscopy, 2009
    Co-Authors: Huseyin Aktas, Peter Mensink, Jelle Haringsma, Ernst J Kuipers
    Abstract:

    Background and study aim Reported complications of double-balloon enteroscopy (DBE) include post-enteroscopy pancreatitis. Hyperamylasemia after proximal DBE is reported frequently, but the relationship to development of pancreatitis remains unclear. Hyperamylasemia may be related to balloon inflation in the pancreatic head region. The aims of the study were to identify risk factors for Hyperamylasemia and to determine the incidence of Hyperamylasemia and pancreatitis when a modified cautious DBE insertion protocol was used. Patients and methods In a prospective study, involving consecutive patients undergoing a proximal DBE, serum amylase activity was assessed immediately before and after the procedure. Results 135 patients were included (men 78, women 57; mean age 49 years [range 17 - 88]). The mean total procedure time was 73 minutes (range 30 - 150 minutes), and mean number of passes during the proximal DBE was 14 (6 - 24). While patients (17 %) developed Hyperamylasemia after the DBE procedure, only one patient with Hyperamylasemia had clinical symptoms indicating a mild acute pancreatitis (0.7 %). Total procedure time and number of passes correlated significantly with the occurrence of Hyperamylasemia. Conclusions We found a low incidence of Hyperamylasemia and pancreatitis post-DBE. Theoretically, this could result from the modified insertion technique, with local strain and friction of the small bowel as remaining causes of Hyperamylasemia, a notion supported by the significant relation between Hyperamylasemia and duration of DBE and total number of passes. We therefore advise use of the cautious insertion technique and, if possible, reduction of duration and of number of passes in every proximal DBE.

Mauro Panteghini - One of the best experts on this subject based on the ideXlab platform.

  • frequency of pancreatic Hyperamylasemia in human immunodeficiency virus positive patients in the highly active antiretroviral therapy era
    American Journal of Clinical Pathology, 2016
    Co-Authors: Dominika Szőke, Annalisa Ridolfo, C Valente, Massimo Galli, Mauro Panteghini
    Abstract:

    Objectives: Increased frequency of Hyperamylasemia has previously been reported in human immunodeficiency virus (HIV)-positive patients, but studies determined total amylase activity and were performed before the introduction of highly active antiretroviral therapy (HAART). We evaluated the frequency of pancreatic Hyperamylasemia in a large HIV+ population mostly treated with HAART. Methods: The upper reference limit (URL) for pancreatic amylase (P-AMY) was derived from 299 healthy blood donors. A cross-sectional study was then performed on samples obtained from 1,548 consecutive patients referred to our infectious disease clinic to assess serum P-AMY and lipase concentrations. Of the patients, 94% were HIV+, and most (92%) were taking HAART (HIV+Tx+). Results: P-AMY URL was 51 U/L. The frequency of P-AMY increase did not significantly differ between HIV+ and HIV - populations (14.2% vs 15.2%, P = .91) or between HIV+Tx+ and HIV+Tx - (14.7% vs 8.9%, P = .11). In almost half (48.3% of HIV+ and 42.9% of HIV -) of hyperamylasemic patients, lipase was normal, indicating a non pancreatic origin of their P-AMY increase. Markedly elevated P-AMY (>3 times the URL) was found in six HIV+ patients and in one HIV - patient: two had macroamylasemia, one acute pancreatitis, three (including the HIV - patient) chronic pancreatitis, and one chronic Hyperamylasemia of undefined origin. Conclusions: In our study, both HIV+ and HIV+Tx+ do not show an increased frequency of P-AMY elevation. Frank pancreatic disease is rare in this clinical setting.

  • Frequency of Pancreatic Hyperamylasemia in Human Immunodeficiency Virus–Positive Patients in the Highly Active Antiretroviral Therapy Era
    'Oxford University Press (OUP)', 2016
    Co-Authors: D. Szoke, Annalisa Ridolfo, C Valente, Massimo Galli, Mauro Panteghini
    Abstract:

    Objectives: Increased frequency of Hyperamylasemia has previously been reported in human immunodeficiency virus (HIV)-positive patients, but studies determined total amylase activity and were performed before the introduction of highly active antiretroviral therapy (HAART). We evaluated the frequency of pancreatic Hyperamylasemia in a large HIV\ufe population mostly treated with HAART. Methods: The upper reference limit (URL) for pancreatic amylase (P-AMY) was derived from 299 healthy blood donors. A cross-sectional study was then performed on samples obtained from 1,548 consecutive patients referred to our infectious disease clinic to assess serum P-AMY and lipase concentrations. Of the patients, 94% were HIV\ufe, and most (92%) were taking HAART (HIV\ufeTx\ufe). Results: P-AMY URL was 51 U/L. The frequency of P-AMY increase did not significantly differ between HIV\ufe and HIV - populations (14.2% vs 15.2%, P\ubc.91) or between HIV\ufeTx\ufe and HIV\ufeTx - (14.7% vs 8.9%, P\ubc.11). In almost half (48.3% of HIV\ufe and 42.9% of HIV -) of hyperamylasemic patients, lipase was normal, indicating a non pancreatic origin of their P-AMY increase. Markedly elevated P-AMY (>3times the URL) was found in six HIV\ufe patients and in one HIV - patient: two had macroamylasemia, one acute pancreatitis, three (including the HIV - patient) chronic pancreatitis, and one chronic Hyperamylasemia of undefined origin. Conclusions: In our study, both HIV\ufe and HIV\ufeTx\ufe do not show an increased frequency of P-AMY elevation. Frank pancreatic disease is rare in this clinical setting

Zhendong Jin - One of the best experts on this subject based on the ideXlab platform.

  • incidence of Hyperamylasemia after endoscopic ultrasound guided fine needle aspiration of pancreatic lesions a multicenter study from china
    Pancreas, 2012
    Co-Authors: Kaixuan Wang, Siyu Sun, Jing Sheng, Xianbao Zhan, Aimin Yang, Xiujiang Yang, Yi Cui, Qiwen Ben, Zhendong Jin
    Abstract:

    Objectives There have been few reports regarding the incidence of Hyperamylasemia after endoscopic ultrasound-guided fine needle aspiration (EUS-FNA). In particular, the potential risk factors involved in the development of Hyperamylasemia have not been analyzed owing to the small number of cases reported. The aim of this study was to evaluate Hyperamylasemia and associated risk factors after EUS-FNA of a large sample of pancreatic lesions. Methods Patients who underwent EUS-FNA for treatment of a pancreatic lesion were recruited from 6 medical centers in China. Results A total of 1023 patients presenting with pancreatic lesions between January 2004 and June 2008 were enrolled in this study, with 48 (4.7%) of the 1023 patients presenting with Hyperamylasemia 3 hours after the procedure. These patients had a mean ± SD serum amylase level of 331.64 ± 138.60 UI/L. With the use of unconditional logistic regression analysis, the incidence of Hyperamylasemia was found to be affected by the type of cystic lesion present and the gauge of the needle used. In 4 (0.4%) of the 1023 patients, acute pancreatitis developed. Conclusions The overall incidence of Hyperamylasemia after EUS-FNA is relatively low. However, the type of cystic lesion present and the gauge of the needle (19G) used for EUS-FNA may represent risk factors for the incidence of Hyperamylasemia.

J Llach - One of the best experts on this subject based on the ideXlab platform.

  • incidence and clinical significance of Hyperamylasemia after endoscopic ultrasound guided fine needle aspiration eus fna of pancreatic lesions a prospective and controlled study
    Endoscopy, 2007
    Co-Authors: Gloria Fernandezesparrach, Angels Gines, P Garcia, Maria Pellise, Manel Sole, P Cortes, Antonio Z Gimenogarcia, Oriol Sendino, Salvador Navarro, J Llach
    Abstract:

    BACKGROUND AND STUDY AIM Acute pancreatitis as a complication of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of pancreatic lesions is rarely observed. However, there is little information on the incidence of Hyperamylasemia after EUS-FNA of the pancreas and its clinical significance. This study aimed to supply this lack of information. PATIENTS AND METHODS Patients who underwent EUS-FNA of a pancreatic lesion between October 2004 and October 2005 were studied prospectively. Exclusion criteria were: (i) platelet count under 50,000/mm (3) and/or prothrombin time < 50 %; (ii) performance of surgery, endoscopic retrograde cholangiopancreatography (ERCP), a percutaneous biopsy attempt, or another invasive procedure within 7 days before EUS-FNA; (iii) lack of informed consent. Serum amylase levels were determined before and 8 and 24 h after the procedure. Hyperamylasemia was defined by amylase levels above 104 UI/L (and higher than baseline levels) 8 h after the procedure. Acute pancreatitis was defined by upper abdominal pain (with or without nausea and/or vomiting) accompanied by elevation of serum amylase or lipase to at least twice baseline levels. RESULTS A total of 100 patients underwent EUS-FNA of a pancreatic lesion (58 men, 42 women; mean age 60 +/- 13 years). Eleven patients (11 %) showed Hyperamylasemia 8 h after the puncture (298 +/- 293 UI/L, range 105 - 1044 UI/L), but only two of them developed acute mild pancreatitis after EUS-FNA. Hyperamylasemia was not related either to the type of lesion (cystic or solid) or to its location, the duration of the procedure, or the number of passes performed. CONCLUSIONS Pancreatitis after pancreatic EUS-FNA occurs in 2 % of patients, with some more cases of silent Hyperamylasemia. This complication may have to be included in the information given to patients for their informed consent.

Huseyin Aktas - One of the best experts on this subject based on the ideXlab platform.

  • Hyperamylasemia and pancreatitis following spiral enteroscopy
    Canadian Journal of Gastroenterology & Hepatology, 2012
    Co-Authors: Christopher W Teshima, Huseyin Aktas, Ernst J Kuipers, Peter Mensink
    Abstract:

    BACKGROUND: Acute pancreatitis is a significant potential complication with double-balloon enteroscopy. Hyperamylasemia is frequently observed after both double-balloon enteroscopy and single-balloon enteroscopy but often without associated pancreatitis. Whether the same phenomenon occurs with spiral enteroscopy is currently unknown.

  • complications of single balloon enteroscopy a prospective evaluation of 166 procedures
    Endoscopy, 2010
    Co-Authors: Huseyin Aktas, Jelle Haringsma, L De Ridder, E J Kuipers, Peter Mensink
    Abstract:

    Background and study aim: Double-balloon enteroscopy (DBE) has proven to be a relatively safe method for small-bowel evaluation, with a complication rate of 1%. The main concern after diagnostic DBE is acute pancreatitis. Single-balloon enteroscopy (SBE) has emerged as a viable alternative to DBE. Until now, no incidence of pancreatitis has been reported for SBE. The aims were to evaluate complication rate and occurrence of Hyperamylasemia and to identify the risk factors for Hyperamylasemia after SBE. Patients and methods: Prospectively, consecutive patients undergoing peroral ("proximal") or combined approach SBE were included. Complications were assessed at 1 and 30 days afterwards. Serum amylase and C-reactive protein (CRP) were assessed immediately before and 23 hours after SBE. Results: 166 SBE procedures were performed in 105 patients (53-male; mean age 51 years, range 9-87). The indications for SBE were: anemia (n = 55), Crohn's disease (n = 31) and abdominal complaints suspicious for inflammatory bowel disease (n = 5), Peutz-Jeghers syndrome (n = 1) and other (n = 13). Therapeutic interventions were performed during 21 procedures (13 %). One perforation (1/21 therapeutic interventions, 4.8 %) occurred after dilation of a benign stricture. While 13 patients (16 %) had post-SBE Hyperamylasemia, none had complaints suggesting acute pancreatitis. Factors such as sex, indication, procedure duration, number of passes, route of SBE, findings, and/or treatment showed no significant correlation with presence of Hyperamylasemia. Conclusions: SBE appears to be a safe diagnostic endoscopic procedure. The incidence of Hyperamylasemia and pancreatitis after peroral SBE seems comparable to that after DBE.

  • low incidence of Hyperamylasemia after proximal double balloon enteroscopy has the insertion technique improved
    Endoscopy, 2009
    Co-Authors: Huseyin Aktas, Peter Mensink, Jelle Haringsma, Ernst J Kuipers
    Abstract:

    Background and study aim Reported complications of double-balloon enteroscopy (DBE) include post-enteroscopy pancreatitis. Hyperamylasemia after proximal DBE is reported frequently, but the relationship to development of pancreatitis remains unclear. Hyperamylasemia may be related to balloon inflation in the pancreatic head region. The aims of the study were to identify risk factors for Hyperamylasemia and to determine the incidence of Hyperamylasemia and pancreatitis when a modified cautious DBE insertion protocol was used. Patients and methods In a prospective study, involving consecutive patients undergoing a proximal DBE, serum amylase activity was assessed immediately before and after the procedure. Results 135 patients were included (men 78, women 57; mean age 49 years [range 17 - 88]). The mean total procedure time was 73 minutes (range 30 - 150 minutes), and mean number of passes during the proximal DBE was 14 (6 - 24). While patients (17 %) developed Hyperamylasemia after the DBE procedure, only one patient with Hyperamylasemia had clinical symptoms indicating a mild acute pancreatitis (0.7 %). Total procedure time and number of passes correlated significantly with the occurrence of Hyperamylasemia. Conclusions We found a low incidence of Hyperamylasemia and pancreatitis post-DBE. Theoretically, this could result from the modified insertion technique, with local strain and friction of the small bowel as remaining causes of Hyperamylasemia, a notion supported by the significant relation between Hyperamylasemia and duration of DBE and total number of passes. We therefore advise use of the cautious insertion technique and, if possible, reduction of duration and of number of passes in every proximal DBE.