Amylase and lipase measurements in paediatric patients with traumatic pancreatic injuries

Introduction: Pancreatic injuries occur in up to 10% of paediatric patients who suffer blunt trauma. Initial amylase and lipase measurements have not been helpful as a screening tool to detect pancreatic injuries. However, one primarily adult study suggests that a delayed measurement may be useful. Materials and methods: A retrospective chart review was conducted of patients admitted to a Level I paediatric trauma centre from April 1996 to November 2006 with traumatic pancreatic injuries. Results: The trauma database identified 51 patients with traumatic pancreatic injuries. Inclusion and exclusion criteria were met by 26 patients. Patients with initial amylase and lipase levels measured greater than 2 h post-injury were more consistently elevated compared to those patients who had levels measured at 2 h or less post-injury. There was a significant association between time of measurement and an increased amylase level (p = 0.012). No significant association was found for lipase measurements (p = 0.178). Discussion and conclusions: In children with blunt pancreatic injury, elevated serum amylase levels were seen in a significantly higher percentage of patients with initial measurements at greater than 2 h post-injury compared to those measured at 2 h or less. Lipase measurements demonstrated a similar trend. Delayed amylase and lipase measurements may be helpful to detect pancreatic injuries, but further study is needed.