Amylase Enzymatic, Pleural Fluid Test

The amylase enzymatic, pleural fluid test measures the concentration of amylase in the pleural fluid. It uses a colorimetric method that detects the change in color of a substrate when it is broken down by amylase.

The amylase enzymatic, pleural fluid test is done to help diagnose and monitor conditions that affect the pancreas, the salivary glands, or the pleura. These conditions include: • Pancreatitis: inflammation of the pancreas that can cause severe abdominal pain, nausea, vomiting, fever, and elevated blood amylase levels. • Pancreatic pseudocyst: a collection of fluid and debris that forms around the pancreas due to pancreatitis or trauma. It can compress nearby organs and cause pain, infection, or bleeding. • Pancreatic fistula: an abnormal connection between the pancreas and another organ or cavity, such as the pleura. It can result from surgery, trauma, or inflammation of the pancreas. It can cause leakage of pancreatic enzymes and fluids into the pleural space. • Esophageal rupture: a tear in the wall of the esophagus that can occur due to vomiting, trauma, or ingestion of foreign objects. It can cause air and food to enter the pleural cavity and cause infection, inflammation, or bleeding. • Salivary gland disorders: inflammation, infection, or obstruction of the salivary glands that can cause pain, swelling, dry mouth, or difficulty swallowing. They can also cause increased production or leakage of salivary amylase into the blood or the pleural fluid.

The amylase enzymatic, pleural fluid test may be recommended in the following situations: • When a patient has symptoms or signs of a pancreatic disorder, such as abdominal pain, nausea, vomiting, fever, weight loss, or jaundice. • When a patient has an abnormal chest X-ray or CT scan that shows fluid accumulation in the pleural space (pleural effusion). • When a patient has a history of pancreatitis, pancreatic surgery, trauma to the chest or abdomen, or esophageal disease. • When a patient has a suspected salivary gland disorder that may affect the amylase levels in the blood or the pleural fluid.

A positive result in the amylase enzymatic, pleural fluid test means that there is an increased level of amylase in the pleural fluid. This can indicate one of the following conditions: • Pancreatitis • Pancreatic pseudocyst • Pancreatic fistula • Esophageal rupture • Salivary gland disorder

The test involves collecting a sample of pleural fluid from the patient. Thoracentesis is a procedure used to do this. In this procedure: • The patient is positioned on a bed or a chair with their arms raised and resting on pillows. • The skin over the chest wall is cleaned and numbed with a local anesthetic. • A thin needle is inserted through the chest wall into the pleural space under ultrasound guidance. • A syringe is attached to the needle and used to withdraw some fluid from the pleural space. • The needle is removed and a bandage is applied over the puncture site. • The fluid sample is sent to a laboratory for analysis. The procedure usually takes about 15 to 20 minutes and causes minimal discomfort.

Patients may be advised to follow some instructions before the test, such as: • Informing their doctor about any medications or supplements they are taking • Avoiding food and drink for a couple hours before the test

• Amylase blood test: to measure the level of amylase in the blood and compare it with the level in the pleural fluid • Lipase blood test: to measure the level of lipase, another enzyme produced by the pancreas, in the blood • Pleural fluid analysis: to examine the physical, chemical, and microscopic characteristics of the pleural fluid and look for signs of infection, inflammation, or malignancy • Pleural fluid culture: to identify any bacteria or fungi that may be causing an infection in the pleural space • Pleural fluid cytology: to look for any abnormal cells that may indicate cancer or other diseases in the pleura

• Amylase, pleural fluid • Pleural fluid amylase