Curbside Consultation in Endoscopy: 49 Clinical Questions, Second Edition

Joseph Leung, MD; Simon Lo, MD

Question 38: A 25-Year-Old Female Presents With Recurrent Abdominal Pain And Mildly Elevated Serum Amylase And Lipase Levels, Normal Lfts. Abdominal Imaging Shows Normal Size Cbd, Pd, And No Obvious Stones In The Gallbladder. What Should I Do Next? (continued)

Harry Aslanian, MD; James J. Farrell, MD

Although mild elevations of amylase and lipase may be due to nonpancreatitic causes such as disorders that inflame the small intestine, including celiac sprue or Crohn’s disease (which could also account for the patient’s pain), elevations of serum amylase and lipase greater than twice normal are more specific for acute pancreatitis. The initial workup for a young woman with recurrent acute pancreatitis should be focused on identifying the etiology of the acute pancreatitis so that future episodes could potentially be prevented.1 Alcohol intake and gallstones account for…