ORIGINAL ARTICLE

JOP. J. Pancreas (Online) 2003; 4(6):200-206.

Pancreatic Involvement in Salmonella Infection

Raffaele Pezzilli1, Antonio M Morselli-Labate1, Bhajat Barakat2, Elisabetta Romboli1, Rosa Ceciliato1, Lidia Piscitelli1, Roberto Corinaldesi1

1Department of Internal Medicine and Gastroenterology, Alma Mater Studiorum - University of Bologna. 2Department of Emergency Medicine, Sant’Orsola-M.Malpighi Hospital. Bologna, Italy

ABSTRACT

Context Salmonella has been identified as a causative agent of acute pancreatitis.

Objective We prospectively evaluated the frequency of acute pancreatitis, pancreatic enzyme elevation and morphological pancreatic abnormalities in patients with Salmonella infection.

Subjects Thirty consecutive patients with salmonellosis (Salmonella enterica serovar Enteritidis: n=25; Salmonella enterica serovar Typhimurium: n=5) and 30 sex- and age-matched healthy subjects were studied.

Main outcome measures All subjects underwent serum amylase and lipase determination and ultrasonography.

Results None of the subjects developed acute pancreatitis. Two patients (6.7%) and two controls showed serum amylase activity above the upper reference limit whereas, in five patients (16.7%) and one control subject (3.3%), the serum lipase activity appeared above the upper reference limit. Salmonella infection significantly increased serum activity of lipase (P<0.001) while it did not significantly affect serum amylase levels (P=0.204). Serum lipase activity was significantly higher in patients infected by Salmonella enterica serovar Typhimurium than in those infected by Salmonella enterica serovar Enteritidis (P=0.012). Ultrasonography did not show pancreatic abnormalities in any of the subjects.

Conclusions Our data demonstrated an elevation of serum lipase activity in gastroenteritis due to Salmonella infection, but this elevation does not seem to have clinical significance. The elevation of serum lipase seems to be particularly related to infection from Salmonella enterica serovar Typhimurium.

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Keywords Amylases; Lipase; Pancreatitis, Acute Necrotizing; Salmonella enterica; Salmonella enteritidis; Salmonella typhimurium

Correspondence Raffaele Pezzilli: pezzilli@orsola-malpighi.med.unibo.it