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VALUE OF BLOOD AMYLASE ESTIMATIONS IN THE DIAGNOSIS OF PANCREATIC DISEASE: A CLINICAL STUDY

VALUE OF BLOOD AMYLASE ESTIMATIONS IN THE DIAGNOSIS OF PANCREATIC DISEASE: A CLINICAL STUDY Abstract The clinical diagnosis of disease of the pancreas1 has always been fraught with great difficulty. Whether one is dealing with the dramatic suddenness of an acute hemorrhagic pancreatitis, the silent jaundice in carcinoma at the head of the pancreas, the variable and indefinite symptomatology of chronic pancreatitis or the insidiously developing pancreatic cyst, a large proportion of pancreatic lesions remain unrecognized clinically and are first diagnosed at laparotomy or at postmortem examination. This is not because the pancreas is so rarely the seat of disease, for it is diseased far more frequently than is generally supposed. Among the 60,000 patients admitted to Barnes Hospital but 150, or 0.25 per cent of the cases, bore a diagnosis of pancreatic disease of one kind or another, exclusive of diabetes mellitus, while among the last 3,600 autopsies performed at the Washington University School of Medicine, gross or microscopic lesions of the acinar References 1. Only disease of the external secretion is here considered. Glycosuria as a sign of lesion in the islets, when noted, was secondary to disease of the acini and ducts. 2. Barron, M.: Disease of Pancreas, Pathologic Study, with Report of Cases , Arch. Int. Med. 35:807 ( (June) ) 1925.Crossref 3. Moench, G. L.: Acute Pancreatitis with Erosion of Splenic Artery and Fatal Hemorrhage , J. A. M. A. 82:360 ( (Feb. 2) ) 1924.Crossref 4. Gross, O., and Guleke, N.: Die Erkrankungen des Pankreas , Berlin, Julius Springer, 1924, p. 39. 5. Foster, M.: J. Anat. & Physiol. 1:107, 1867. 6. Carlson, A. J., and Luckhardt, A. B.: Am. J. Physiol. 23:148, 1908. 7. Bainbridge, F. A., and Beddard, A. P.: Biochem. J. 2:89, 1907. 8. Milne, L. S., and Peters, H. L.: J. M. Research 26:415, 1912. 9. Davis, L. H., and Ross, E. L.: Am. J. Physiol. 56:22, 1921. 10. Schlesinger, W.: Verhandl. d. Kong. f. inn. Med. 25:505, 1908 11. Deutsche med. Wchnschr. 34:593, 1908. 12. King, C. E.: Am. J. Physiol. 35:301, 1914. 13. Wohlgemuth, J.: Verhandl. d. Kong. f. inn. Med. 25:501, 1908. 14. Moeckel, K., and Rost, F.: Ztschr. f. physiol. Chem. 67:433, 1910. 15. Lepine, R., and Barral, M.: Compt. rend. Acad. d. sc. 113:729, 1891. 16. Kaufmann, M.: Compt. rend. Soc. de biol. 46:130, 1894. 17. Gould, L. K., and Carlson, A. J.: Am. J. Physiol. 29:165, 1912. 18. Otten, H., and Galloway, T. C., Jr.: Am. J. Physiol. 26:347, 1910. 19. Korowin: Malys Jahresb. 3:158, 1873. 20. Roberts, W.: Proc. Roy. Soc. Med. 32:145, 1881. 21. Bayliss, W.: Theory of Enzyme Action , New York, Longmans Green & Company, 1924, ed. 5, p. 52. 22. Clerc, A., and Loeper, M.: Compt. rend. Soc. de biol. 66:871, 1909. 23. Wohlgemuth, J.: Biochem. Ztschr. 9:1, 1908. 24. Von Benczur, J.: Wien. med. Wchnschr. 23:890, 1910. 25. Corbett, D.: Quart. J. Med. 6:351, 1912. 26. Stafford, D. D., and Addis, T.: Quart. J. Med. 17:151, 1924.Crossref 27. Cohen, I.: Brit. J. Exper. Path. 6:173, 1925. 28. Stocks, P.: Quart. J. Med. 9:216, 1916.Crossref 29. Reid, C.: Brit. J. Exper. Path. 6:314, 1925. 30. Meyer, V. C., and Killian, J. A.: J. Biol. Chem. 29:179, 1917. 31. Lewis, D. S., and Mason, E. H.: J. Biol. Chem. 44:455, 1920. 32. Elman, R., and McCaughan, J. M.: Quantitative Determination of Blood Amylase with Viscosimeter , Arch. Int. Med. 40:58 ( (July) ) 1927.Crossref 33. Graham, E. A.; Cole, W. H.; Copher, G. H., and Moore, S.: Diseases of the Gallbladder and Bile Ducts , Philadelphia, Lea & Febiger, 1928. 34. Nicoll, J. H.: Brit. M. J. 2:625, 1919.Crossref 35. Opie, E. L.: Diseases of the Pancreas , Philadelphia, J. B. Lippincott Company, 1911. 36. Elman, R., and McCaughan, J. M.: J. Exper. Med. 45:561, 1927.Crossref 37. Balo, J., and Ballon, H. C.: Surg. Gynec. Obst. 48:1, 1929. 38. Van de Erve, J.: Am. J. Physiol. 29:182, 1911. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

VALUE OF BLOOD AMYLASE ESTIMATIONS IN THE DIAGNOSIS OF PANCREATIC DISEASE: A CLINICAL STUDY

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Publisher
American Medical Association
Copyright
Copyright © 1929 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1929.01150060005001
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Abstract

Abstract The clinical diagnosis of disease of the pancreas1 has always been fraught with great difficulty. Whether one is dealing with the dramatic suddenness of an acute hemorrhagic pancreatitis, the silent jaundice in carcinoma at the head of the pancreas, the variable and indefinite symptomatology of chronic pancreatitis or the insidiously developing pancreatic cyst, a large proportion of pancreatic lesions remain unrecognized clinically and are first diagnosed at laparotomy or at postmortem examination. This is not because the pancreas is so rarely the seat of disease, for it is diseased far more frequently than is generally supposed. Among the 60,000 patients admitted to Barnes Hospital but 150, or 0.25 per cent of the cases, bore a diagnosis of pancreatic disease of one kind or another, exclusive of diabetes mellitus, while among the last 3,600 autopsies performed at the Washington University School of Medicine, gross or microscopic lesions of the acinar References 1. Only disease of the external secretion is here considered. Glycosuria as a sign of lesion in the islets, when noted, was secondary to disease of the acini and ducts. 2. Barron, M.: Disease of Pancreas, Pathologic Study, with Report of Cases , Arch. Int. Med. 35:807 ( (June) ) 1925.Crossref 3. Moench, G. L.: Acute Pancreatitis with Erosion of Splenic Artery and Fatal Hemorrhage , J. A. M. A. 82:360 ( (Feb. 2) ) 1924.Crossref 4. Gross, O., and Guleke, N.: Die Erkrankungen des Pankreas , Berlin, Julius Springer, 1924, p. 39. 5. Foster, M.: J. Anat. & Physiol. 1:107, 1867. 6. Carlson, A. J., and Luckhardt, A. B.: Am. J. Physiol. 23:148, 1908. 7. Bainbridge, F. A., and Beddard, A. P.: Biochem. J. 2:89, 1907. 8. Milne, L. S., and Peters, H. L.: J. M. Research 26:415, 1912. 9. Davis, L. H., and Ross, E. L.: Am. J. Physiol. 56:22, 1921. 10. Schlesinger, W.: Verhandl. d. Kong. f. inn. Med. 25:505, 1908 11. Deutsche med. Wchnschr. 34:593, 1908. 12. King, C. E.: Am. J. Physiol. 35:301, 1914. 13. Wohlgemuth, J.: Verhandl. d. Kong. f. inn. Med. 25:501, 1908. 14. Moeckel, K., and Rost, F.: Ztschr. f. physiol. Chem. 67:433, 1910. 15. Lepine, R., and Barral, M.: Compt. rend. Acad. d. sc. 113:729, 1891. 16. Kaufmann, M.: Compt. rend. Soc. de biol. 46:130, 1894. 17. Gould, L. K., and Carlson, A. J.: Am. J. Physiol. 29:165, 1912. 18. Otten, H., and Galloway, T. C., Jr.: Am. J. Physiol. 26:347, 1910. 19. Korowin: Malys Jahresb. 3:158, 1873. 20. Roberts, W.: Proc. Roy. Soc. Med. 32:145, 1881. 21. Bayliss, W.: Theory of Enzyme Action , New York, Longmans Green & Company, 1924, ed. 5, p. 52. 22. Clerc, A., and Loeper, M.: Compt. rend. Soc. de biol. 66:871, 1909. 23. Wohlgemuth, J.: Biochem. Ztschr. 9:1, 1908. 24. Von Benczur, J.: Wien. med. Wchnschr. 23:890, 1910. 25. Corbett, D.: Quart. J. Med. 6:351, 1912. 26. Stafford, D. D., and Addis, T.: Quart. J. Med. 17:151, 1924.Crossref 27. Cohen, I.: Brit. J. Exper. Path. 6:173, 1925. 28. Stocks, P.: Quart. J. Med. 9:216, 1916.Crossref 29. Reid, C.: Brit. J. Exper. Path. 6:314, 1925. 30. Meyer, V. C., and Killian, J. A.: J. Biol. Chem. 29:179, 1917. 31. Lewis, D. S., and Mason, E. H.: J. Biol. Chem. 44:455, 1920. 32. Elman, R., and McCaughan, J. M.: Quantitative Determination of Blood Amylase with Viscosimeter , Arch. Int. Med. 40:58 ( (July) ) 1927.Crossref 33. Graham, E. A.; Cole, W. H.; Copher, G. H., and Moore, S.: Diseases of the Gallbladder and Bile Ducts , Philadelphia, Lea & Febiger, 1928. 34. Nicoll, J. H.: Brit. M. J. 2:625, 1919.Crossref 35. Opie, E. L.: Diseases of the Pancreas , Philadelphia, J. B. Lippincott Company, 1911. 36. Elman, R., and McCaughan, J. M.: J. Exper. Med. 45:561, 1927.Crossref 37. Balo, J., and Ballon, H. C.: Surg. Gynec. Obst. 48:1, 1929. 38. Van de Erve, J.: Am. J. Physiol. 29:182, 1911.

Journal

Archives of SurgeryAmerican Medical Association

Published: Dec 1, 1929

References