Pancreatic Enzymes in Acute Pancreatitis

A lipase result is a clue, not a diagnosis. Pancreatic acinar injury allows digestive enzymes to escape into the circulation, but the same laboratory abnormality can occur with kidney impairment, diabetic ketoacidosis (DKA), critical illness, and abdominal emergencies outside the pancreas. The useful clinical question is therefore not “How high is the lipase?” It is: “Does this patient’s pain, timing, physiology, and imaging support acute pancreatitis, and are they becoming systemically unwell?” Enzyme concentration helps establish the diagnosis; perfusion, respiratory status, organ function, and complications determine urgency.