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April 4, 1959


Author Affiliations

Los Angeles

From the Section on Gastroenterology, Veterans Administration Center, and the departments of medicine and physiology, University of California Medical Center.

JAMA. 1959;169(14):1567-1570. doi:10.1001/jama.1959.03000310019003

The fact that pancreatitis and disease of the biliary tract frequently occur together has led to many types of experiment on possible interactions between bile and pancreatic juice. Especially tempting is the hypothesis that some constituent in bile, in tissue juices, or in inflammatory exudates is capable of activating pancreatic juice and so causing the familiar picture of hemorrhagic necrosis of the pancreas. There is also a tendency to assume that the appearance of abnormal enzymes in the circulation during pancreatitis means that they were produced in the pancreas and are responsible for the symptoms of shock. In reality, the injurious factor in pancreatitis has not yet been identified, and the role played by circulating proteases remains to be explained.