Hyperamylasemia of uncertain significance associated with oral double-balloon enteroscopy

Abstract

Background: Double-balloon enterocopy (DBE) is still under evaluation, including its yield and safety aspects.

Objective: Our purpose was to consider the relationship between DBE and hyperamylasemia.

Design: Single-center prospective study.

Setting: Tertiary referral hospital, conducted from March to October 2006.

Patients: Thirty-five oral DBEs were carried out in 31 patients (17 men, 14 women). Serum amylase, lipase, C-reactive protein (CRP), and urine amylase were taken before the procedure and 4 and 24 hours after the investigation. Abdominal pain was evaluated with a 3-step scale.

Main outcome measurements: Only 1 patient had acute pancreatitis after DBE.

Results: An elevation of amylase levels after the procedure was found in 51.4% and abdominal pain or nausea or vomiting in 34.3%, but 8.6% of these patients had no hyperamylasemia after DBE. CRP was determined in 25 procedures and the serum lipase level in 14 of these 25 DBEs; elevation of both factors after the procedure was found in 36%. The CRP level was elevated in 60% after the procedure. We found a positive correlation between abdominal pain and serum lipase level (r = 0.72, P = .0032) and negative correlation between abdominal pain and age (r = -0.445, P = .0076). Significant hyperamylasemia seems to be associated with longer duration of DBE (borderline statistically significant, P = .045; 95% CI for difference of means 0.985-82.306).

Limitations: Nonblinded nonrandomized study.

Conclusions: Hyperamylasemia after DBE seems to be rather common, mainly in the longest examinations. Although association of significant hyperamylasemia and acute pancreatitis is possible, it is not obligatory.