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Acute Pancreatitis, Two Attacks with Normal Serum Amylase and Lipase - A Rare Case Report

Santo A Carnazzo, Andrea Musumeci, Rosalia Latino, Paolo D Cannizzaro

Context Acute pancreatitis is most commonly caused by gallstones or chronic alcohol use and accounts for more than 200,000 hospital admissions annually. Guidelines by the American College of Gastroenterology state that the diagnosis of acute pancreatitis requires the presence of two of the following three criteria: 1) abdominal pain consistent with the disease; 2) serum amylase and/or lipase greater than three times the upper limit of normal; 3) characteristic findings from abdominal imaging. Acute pancreatitis with normal serum amylase and/or lipase level in acute pancreatitis is an extremely rare occurrence.

Case report Herein we present a case report with imaging-proven acute pancreatitis with normal serum amylase and lipase levels.

Conclusion Acute pancreatitis is not always associated with increased levels of serum amylase and lipase and these markers can be misleading for the correct diagnosis.