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Normal lipase serum level in acute pancreatitis: a case report
  1. T Cartier1,
  2. P Sogni2,
  3. F Perruche1,
  4. O Meyniard1,
  5. Y-E Claessens1,
  6. J-F Dhainaut1,
  7. G Der Sahakian1
  1. 1Paris Descartes University, Faculty of Medicine; Assistance Publique—Hôpitaux de Paris; Department of Emergency Medicine, Hôpital Cochin, Paris, France
  2. 2Paris Descartes University, Faculty of Medicine; Assistance Publique—Hôpitaux de Paris; Department of Gastroenterology, Hôpital Cochin, Paris, France
  1. Correspondence to:
 Dr G Der Sahakian
 Department of Emergency Medicine, Hôpital Cochin, 27 rue du Faubourg Saint-Jacques F-75679 Paris Cedex 14, France; guillaume.der-sahakian{at}cch.aphp.fr

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Diagnosis of acute pancreatitis relies on clinical symptoms and increase of serum lipase within 48 hours. We report the case of a patient admitted in the emergency department with a 24 hour history of acute abdominal pain. A computed tomography (CT) scan revealed an acute pancreatitis in spite of the lipase serum level being normal.

CASE REPORT

An 84 year old man was referred to our emergency department because of recurrent diffuse abdominal pain and vomiting for 24 hours. He had a history of type 1 diabetes mellitus, dysarthria, and left hemiplegia related to ischaemic stroke. He has previously been operated for suspected bowel related sepsis. He also had been treated for bladder polyps 2 years ago, and had had a left nephrectomy for unknown purpose. His current treatment included subcutaneous insulin, dalteparin (2500 U/day), omeprazole (20 mg/day), and venlafaxine (75 mg/day). He was not an alcoholic and did not smoke. …

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