Hyperamylasemia of uncertain significance associated with oral double-balloon enteroscopy

Background Double-balloon enterocopy (DBE) is still under evaluation, including its yield and safety aspects. Objective Our purpose was to consider the relationship between DBE and hyperamylasemia. Design Single-center prospective study. Setting Tertiary referral hospital, conducted from March to October 2006. Patients Thirty-five oral DBEs were carried out in 31 patients (17 men, 14 women). Serum amylase, lipase, C-reactive protein (CRP), and urine amylase were taken before the procedure and 4 and 24 hours after the investigation. Abdominal pain was evaluated with a 3-step scale. Main Outcome Measurements Only 1 patient had acute pancreatitis after DBE. Results An elevation of amylase levels after the procedure was found in 51.4% and abdominal pain or nausea or vomiting in 34.3%, but 8.6% of these patients had no hyperamylasemia after DBE. CRP was determined in 25 procedures and the serum lipase level in 14 of these 25 DBEs; elevation of both factors after the procedure was found in 36%. The CRP level was elevated in 60% after the procedure. We found a positive correlation between abdominal pain and serum lipase level ( r = 0.72, P = .0032) and negative correlation between abdominal pain and age ( r = –0.445, P = .0076). Significant hyperamylasemia seems to be associated with longer duration of DBE (borderline statistically significant, P = .045; 95% CI for difference of means 0.985-82.306). Limitations Nonblinded nonrandomized study. Conclusions Hyperamylasemia after DBE seems to be rather common, mainly in the longest examinations. Although association of significant hyperamylasemia and acute pancreatitis is possible, it is not obligatory.