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March 1968

A Clinical Trial of an Enzyme Inhibitor in Pancreatitis

Author Affiliations

New Haven, Conn
From the Yale University School of Medicine, New Haven, Conn. Dr. Kneisel is now with the University of Connecticut School of Medicine, Hartford.

Arch Surg. 1968;96(3):442-449. doi:10.1001/archsurg.1968.01330210120025

ACUTE pancreatitis is clinically unpredictable and terminates fatally in enough instances to warrant careful evaluation of any possible therapy. In the more severe disease, activation of its own enzymes results in progression of the pancreatic pathological process. For this reason, a further investigation of a proteinase inhibitor (Trasylol [Germany]) is reported here after its clinical use by the intravenous route. The comparison of a large series of closely matched cases will ultimately provide firm assessment of the enzyme inhibitor. The present study measures several appropriate phenomena in a group of generally comparable cases of acute pancreatitis treated conventionally, with or without the addition of intravenous proteinase inhibitor.

Method  The test enzyme inhibitor was offered to all attending physicians for use in moderately severe or severe acute pancreatitis. Temperatures which reached 100 F (37.8 C) were considered indicative of moderately severe disease while marked hemoconcentration, moderate shock, and toxic or central

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