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As pancreatitis with fat necrosis is not a very common disease I give in the first place an outline of our knowledge concerning it.
The patients are almost exclusively adults. A history of gastro-intestinal disorder dating back for a considerable period is frequently given. Fitz describes the symptoms of acute pancreatitis as follows: "Sudden, severe, often intense epigastric pain, without obvious cause, in most cases followed by nausea, vomiting, sensitiveness and tympanitic swelling of the epigastrium. There is prostration, often extreme, frequent collapse, low fever, with a feeble pulse. Obstinate constipation for several days is the rule, but diarrhea sometimes occurs." The affection is usually fatal.
The symptoms therefore are vague and not very characteristic. The disease has been mistaken for intestinal obstruction, and has been confused with appendicitis. However, a correct antemortem diagnosis has been made more than once. The nature of the affection is not generally revealed until
WILLIAMS HU. RELATION OF FAT NECROSIS TO THE PANCREAS.. JAMA. 1897;XXIX(6):269–271. doi:10.1001/jama.1897.02440320013001f
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