Normal lipase acute pancreatitis: A case report and brief review of literature

Acute pancreatitis is a common presentation in Emergency Department. Elevated amylase and lipase levels are one of three important criteria to diagnose acute pancreatitis. Out of amylase and lipase, the latter is considered more specific for acute pancreatitis. We report a case of acute pancreatitis where serum lipase levels remained always within normal limits. On review of published literature on acute pancreatitis with normal lipase levels, 23 such case reports were retrieved. A brief review, of all these cases including the case presented here, had unknown etiology in 50% of cases followed by alcohol and gallstone. Pain abdomen was the commonest presentation followed by vomiting. Normal discharge could be done in 71% of cases and 17% of patients were non -sur-vivors. Hence, normal lipase cannot rule out acute pancreatitis on its own. A typical presentation of acute pancreatitis needs radiolog-ical workup like an Ultrasound abdomen or CT scan with IV con-trast (if not contraindicated) before refuting its possibility.