Pancreatic fistula laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Pleural or ascitic fluid should be sent for analysis. An elevated amylase level, usually > 1,000 IU/L, with protein levels over 3.0 g/dL is diagnostic. Complete blood count is necessary to check for any ongoing infection or hemorrhage. Complete metabolic panel including inflammatory markers, serum electrolytes, liver function tests, calcium, albumin, amylase and lipase should be sent to laboratory for evaluation. Furthermore, pancreatic fistula leak presenting as ascites or pleural effusion should be analyzed for fluid protein, albumin, lactate dehydrogenase, glucose, gram cultures and total cell count.

Laboratory Findings

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Fluid samples collected via thoracentesis, paracentesis or fluid collected via percutaneous drainage from an external fistula can be analyzed for amylase level, which helps solidify the diagnosis of pancreatic cancer.

  • Bulleted list item

Complete blood count is necessary to check for any ongoing infection or hemorrhage. Complete metabolic panel including inflammatory markers, serum electrolytes, liver function tests, calcium, albumin, amylase and lipase should be sent to laboratory for evaluation.

  • Bulleted list item

Furthermore, pancreatic fistula leak presenting as ascites or pleural effusion should be analyzed for fluid protein, albumin, lactate dehydrogenase, glucose, gram cultures and total cell count. Pancreatic fluid amylase level will be >1000 u/dl.[1][2]

  • Bulleted list item

Pleural or ascitic fluid should be sent for analysis.

    • An elevated amylase level, usually > 1,000 IU/L, with protein levels over 3.0 g/dL is diagnostic.

References

  1. Larsen M, Kozarek R (2014). "Management of pancreatic ductal leaks and fistulae". J Gastroenterol Hepatol. 29 (7): 1360–70. doi:10.1111/jgh.12574. PMID 24650171.
  2. Morgan KA, Adams DB (2007). "Management of internal and external pancreatic fistulas". Surg Clin North Am. 87 (6): 1503–13, x. doi:10.1016/j.suc.2007.08.008. PMID 18053844.

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