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Article
January 19, 1924

ACUTE PANCREATITIS WITH FAT NECROSIS, COMPLICATED BY DIABETIC COMA

JAMA. 1924;82(3):203-204. doi:10.1001/jama.1924.02650290033009

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Abstract

Acute pancreatitis is one of the most fulminating abdominal diseases with which we have to deal. It is one that demands diagnostic acumen, and, with very few exceptions, surgery is the treatment of choice. The most characteristic symptoms are severe, persistent pain in the midepigastrium just above the umbilicus, vomiting and shock. No time must be lost in opening the abdomen, as a fatal outcome' will supervene in a few hours if this is not done.

The exception for not opening the abdomen in these cases is when diabetic coma complicates the pancreatitis. This is rare, but is occasionally encountered, as demonstrated by the following case report. Incidentally, the case illustrates the value of insulin in the treatment of diabetic coma.

REPORT OF CASE 

History.  —Mrs. C. H., aged 59, was admitted to the hospital in a semicomatose state. Her family history was not significant. For many years, possibly five,

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