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December 1958

Gross Autopsy Findings in Cases of Fatal Acute Pancreatitis

Author Affiliations

From the Department of Surgery, State University of New York Downstate Medical Center, Brooklyn.

AMA Arch Surg. 1958;77(6):985-991. doi:10.1001/archsurg.1958.01290050155029

Acute pancreatitis is still a very important and unsolved clinical problem. The mortality rate among patients managed even in the best hospitals is disappointingly high. At the present time the consensus indicates that the accepted treatment is nonoperative, operation being reserved only for those patients who develop complications that must be handled by surgical drainage of one form or another.

The symptoms presented by acute pancreatitis are varied; for this reason the diagnosis, often very obvious, can be missed by even the most careful group of clinicians. Unfortunately, also, the study of enzyme derangements in the blood and urine of these patients and the study of x-ray findings are not always specific enough for the clinician to make the diagnosis.

The mechanism of death in this disease is often unknown. Although it has been postulated that a circulating enzyme or enzymes may cause changes in distant organs and tissues, in