ACUTE PANCREATITIS: A CLINICAL REVIEW OF 72 ATTACKS OCCURRING IN 54 PATIENTS

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Abstract
Diagnosis was verified by clinical, laboratory and/or surgical and autopsy findings in all cases. All patients had severe abdominal or back pain on admission. Emphasis was placed on secondary signs helpful in suggesting the diagnosis of pancreatitis. Ecg changes, glycosuria, hyperglycemia, jaundice, small bowel ileus, and segmental pulmonary atelectasis are stressed as important secondary signs. Jaundice was nearly always associated with a surgically correctable biliary tract lesion (stone or stricture). Hyperglycemia was noted in 52.8% of attacks and 20% subsequently developed diabetes mellitus. The judicious use of insulin to control hyperglycemic episodes associated with pancreatitis is discussed. Surgery during an attack of acute pancreatitis considerably increases both morbidity and mortality. The authors therefore recommend medical management for the control of the acute stage. Following convalescence, the biliary tree should be investigated thoroughly and elective operation performed when indicated.

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