PROSPECTIVE STUDY OF SERUM AMYLASE ACTIVITY IN ACUTE ABDOMINAL DISEASES (ACUTE PANCREATITIS, CHOLECYSTITIS, AND INTESTINAL OBSTRUCTION): A COMPARATIVE STUDY

Abstract

Background: Acute abdominal pain is one of the most frequent surgical emergencies, often requiring rapid differentiation between pancreatic and non-pancreatic causes. Among available biochemical markers, serum amylase remains a widely used but sometimes debated diagnostic tool. This study aimed to evaluate the diagnostic significance of serum amylase levels in distinguishing acute pancreatitis from other major acute abdominal conditions acute cholecystitis and intestinal obstruction and to explore its relationship with demographic variables.

Methods: A total of 210 participants were enrolled and categorized into four groups: acute pancreatitis, acute cholecystitis, intestinal obstruction, and healthy controls. Serum amylase levels were measured and analyzed using IBM SPSS Statistics (Version 26). Descriptive statistics, independent-sample t-tests, one-way ANOVA with post hoc Tukey analysis, Pearson’s correlation, and chi-square tests were applied to assess inter-group variations, demographic associations, and categorical relationships.

Results: Mean serum amylase concentrations varied significantly among groups (F(3, 206) = 146.21, p < 0.001). The highest mean level was observed in acute pancreatitis (800.14 ± 414.73 U/L), followed by acute cholecystitis (268.17 ± 144.08 U/L), intestinal obstruction (174.11 ± 76.69 U/L), and controls (63.59 ± 14.66 U/L). The differences between each disease group and controls were statistically significant (p < 0.001). No significant correlation was found between serum amylase and age (r = –0.044, p = 0.522) or gender (p = 0.603). Chi-square analysis revealed a strong association between enzyme category and disease type (χ² = 330.69, p < 0.001).

Conclusion: Serum amylase levels show marked elevation in acute pancreatitis and moderate increases in non-pancreatic abdominal disorders, making it a reliable and accessible biochemical marker for differentiating causes of acute abdomen. The enzyme’s diagnostic interpretation is unaffected by age or gender, confirming its universal applicability. Although not disease-specific, serum amylase remains a cost-effective and valuable first-line investigation, particularly in resource-limited emergency settings when combined with clinical assessment and imaging studies.