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Work-up for abdominal pain, epigastric tenderness, nausea, and vomiting. Such findings characterize acute pancreatitis as well as acute surgical emergencies such as gastrointestinal perforation (eg, peptic ulcer with perforation) or bowel infarct. Amylase is used in the differential diagnosis of acute or chronic pancreatitis, which may or may not in an individual be related to alcoholism. Hypercalcemia related to pancreatitis is described with hyperparathyroidism and other entities. About 80% of subjects with acute pancreatitis have increased serum amylase within 24 hours.