Department of Medicine and Science of Aging, G d' Annunzio University, ItalyFulltext PDF
A 79 years old man was admitted to the Emergency Department (ED) for acute abdominal pain, mainly located in the epigastrium and irradiated to the hips and back. Pain started after a large meal and it was associated to nausea and vomiting. He had history of arterial hypertension, obesity and cholelitiasis. Exams revealed increase of C-reactive protein (CPR), mild Neutrophila Leucocytosis and moderate hyperamylasemia. Abdomen ultrasound was difficult due to gut air interference and abundant adipose tissue. Cardiac and the remaining objective physical examination were within normal limits. Acute biliary pancreatitis was hypothesized, so patient was submitted to fasting and intravenous hydro saline solutions.After few days, clinical conditions worsened with increase of abdominal pain and stupor of new onset. Blood gas analysis revealed metabolic acidosis with elevation in glycemic levels. Hyperglycemia, glycosuria and metabolic acidosis with elevation of ketones in urine leaded to diagnosis of diabetic ketoacidosis.
Tana M. An Unusual Hyperamylasemia. Ann Clin Case Rep. 2019; 4: 1652. ISSN: 2474-1655.