THE TERM acute pancreatitis calls to the mind of most surgeons the relatively uncommon highly fatal acute hemorrhagic form of the disease. To Elman1 must go much of the credit for pointing out the frequency with which the disease occurs in milder form and for emphasizing the necessity for routine determinations of serum amylase in all cases of pain in the upper abdominal area.
The clinical manifestations of the disease vary greatly. In acute hemorrhagic necrosis the attack is ushered in by the sudden onset of agonizing pain in the upper abdominal area, frequently radiating through to the back, accompanied with protracted nausea and vomiting. The patient is prostrated, the pulse weak and thready and examination reveals tenderness and spasm across the upper part of the abdomen. A sense of fulness in the epigastrium is frequently noted, or a mass consisting of the greatly swollen pancreas may be felt.
ANGLEM TJ, LEE WF. ACUTE PANCREATITIS AND ITS SEQUELAE. Arch Surg. 1949;58(4):484-488. doi:10.1001/archsurg.1949.01240030492008