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 level are one of the 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 with a normal lipase level. 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 gall stone. Pain abdomen was the commonest presentation followed by vomiting. The normal discharge could be done in 71% of cases and 17% of patients were non-survivors. Hence, normal lipase cannot rule out acute pancreatitis on its own. A typical presentation of acute pancreatitis needs radiological work up like an Ultrasound abdomen or CT scan with IV contrast (if not contraindicated) before refuting its possibility.