Role of Amylase and Lipase Levels in Diagnosis of Blunt Trauma Abdomen.

INTRODUCTION: Blunt Trauma Abdomen (BTA) is the leading cause of morbidity and mortality amongst all age groups. Spectrum of injury may vary from simple to life threatening multi organ involvement and therefore proper assessment and diagnosis becomes very important. AIM: To evaluate the role of serum amylase and lipase in diagnosis of blunt trauma abdomen. MATERIALS AND METHODS: This study was done on 50 patients with diagnosis of BTA admitted in Dayanand Medical College and Hospital, Ludhiana. Serum amylase and lipase levels were estimated on days 1, 3 and 5 of admission. RESULTS: Road side accident was the most common aetiology accounting for 40 patients. Thirty one patients were less than 35 years of age and 42 patients were males. Abdominal tenderness was the most common per abdomen finding, found in 31 patients, followed by distension, found in 21 patients. The most common organ injured was liver, seen in 27 patients. Fifteen patients underwent laparotomy while 35 patients were managed conservatively. There was statistically significant rise in serum amylase levels on days 1, 3 and 5 in patients with small and large intestinal injury. There was statistically significant rise in serum lipase levels on days 1, 3 and 5 in patients with stomach injury. Raised levels of serum amylase and lipase had a statistically significant prediction for the need of surgery in these patients. CONCLUSION: Serum amylase and lipase levels, when coupled with other laboratory tests and imaging modalities, may have significant role in predicting the site of injury as well as the surgical outcome in patients of BTA.

Role of diagnostic laparoscopy in chronic abdominal conditions with uncertain diagnosis.

INTRODUCTION: Laparoscopy has proved to be an important tool in the minimally invasive exploration of selected patients with chronic abdominal disorders, whose diagnosis remains uncertain, despite exploring the requisite laboratory and imaging investigations like ultrasonography, computed tomography (CT) scan, and the like. MATERIALS AND METHODS: Diagnostic Laparoscopy was conducted on 120 patients, admitted to the Departments of Surgery and Gynecology, Dayanand Medical College and Hospital, Ludhiana, with an uncertain diagnosis after four weeks of onset of symptoms. CONCLUSION: With laparoscopy providing tissue diagnosis, and helping to achieve the final diagnosis without any significant complication and less operative time, it can be safely concluded that diagnostic laparoscopy is a safe, quick, and effective adjunct to non-surgical diagnostic modalities, for establishing a conclusive diagnosis, but whether it will replace imaging studies as a primary modality for diagnosis needs more evidence.