The Study Of Diagnostic Value of Elevation of Serum Amylase as a Predictive Factor for Appendiceal Perforation in Children with Acute Appendicitis

  Background Recent studies indicate increased serum amylase in children with acute appendicitis. The objective of the current study was to determine the diagnostic accuracy of raised serum amylase level in prediction of perforated appendicitis in children with acute appendicitis. Materials and Methods In this cross-sectional study, 61 children (aged 3 to 15 years) who underwent appendectomy surgery due to acute appendicitis at two university hospitals in Kermanshah, Iran, from 2015 to 2016 were included. The diagnosis of appendicitis was confirmed with histopathologic examination. Before surgery, venous samples were obtained and serum amylase, lipase, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase were assayed. The patients were divided into two groups: perforated appendicitis (18 cases) and non-perforated appendicitis (43 cases). The laboratory tests were compared between the two groups. Results The mean (±standard deviation) serum amylase level was 69.2 (±28.9) mg/dL in perforated group and 29.9 (±11) mg/dL in non-perforated group (P< 0.001). At serum level of 46 mg/dL, serum amylase had a sensitivity of 89% and its specificity was 100% in prediction of acute perforated appendicitis.  Conclusion The serum amylase level in perforated appendicitis was significantly higher compared to patients with non-perforated appendicitis. Serum amylase has good diagnostic value in prediction of perforated appendicitis.