A comparative analysis of urine trypsinogen-2 test strip with serum lipase and serum amylase in diagnosis of acute pancreatitis


  • Satish Kumar R. Department of General Surgery, KIMS, Bengaluru, Karnataka, India
  • Ashik Aslam Department of General Surgery, KIMS, Bengaluru, Karnataka, India
  • Nitish S. Department of General Surgery, KIMS, Bengaluru, Karnataka, India
  • Gagan S. Prakash Department of General Surgery, KIMS, Bengaluru, Karnataka, India




Acute pancreatitis, Acute abdomen, Serum amylase, Serum lipase, Urine trypsinogen-2


Background: Acute pancreatitis possess difficulty in diagnosis in its emergency presentation. Hence segregation of this disease from other specific or non-specific causes of acute abdomen is important. In majority of the suspected cases, the urinary trypsinogen-2 test strip can be used to detect this disease, especially in emergency set-up. The aim and objective of the study was to evaluate the sensitivity and specificity of urinary trypsinogen-2 and to compare it with that of the standard biochemical markers of acute pancreatitis serum amylase and serum lipase.

Methods: All patients who presented to the surgical emergency with symptoms and signs suspicious of acute pancreatitis were included in the study, rapid urinary trypsinogen-2 test was done immediately at the bed side, serum amylase and lipase was send for all cases along with routine investigations.

Results: The urinary trypsinogen-2 test was sensitive in 96.1% cases and specific in 82.6% cases. The sensitivity is superior to that of serum lipase (sensitivity-90.2%) and serum amylase (sensitivity-84.3%). The high sensitivity of the urinary trypsinogen-2 test resulted in very high negative predictive value of 90.5%, hence a negative test almost rules out the diagnosis of acute pancreatitis.

Conclusions: In patients with acute abdominal pain with suspicion of acute pancreatitis seen in emergency department, a negative dipstick for urinary trypsinogen-2 rules out acute pancreatitis with high degree of probability and therefore appears to be more suitable for screening of acute pancreatitis.


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