THE AETIOLOGY, COURSE AND SURGICAL ASPECTS OF PANCREATITIS: A REVIEW OF 108 CASES

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Abstract
Summary: 1. A consecutive series of 10s cases of pancreatitis comprised 29 patients who had a single acute attack, 73 who developed chronic relapsing pancreatitis, and 6 who presentedwith chronic “silent pancreatitis.2. Gall‐stones in 46 patients and alcoholism in 24 patients were common associated conditions. Trauma, vascular disease and viral infection were true aetiological factors in some cases.3. Laboratory studies disclosed jaundice in 29 cases, hyperlipaemia in 24 cases, disturbed glucose tolerance in 27 cases and an abnormal secretin test in 14 cases.4. Surgical biopsies in relapsing pancreatitis showed a wide variety of histological appearances.5. Ten deaths resulted from pancreatitis. Frank diabetes occurred in 16 patients and was directly related to the frequency of attacks of pancreatitis. Pancreatic insufficiency with steatorrhoea was rare except in chronic insidious pancreatitis.6. In relapsing pancreatitis, remissions of two or more years eventually occurred in 44 per cent. of all cases, and in 36 per cent. of those who were not treated surgically. It is suggested that results of surgical treatment in pancreatitis be evaluated in terms of the expected cure rate in patients not receiving surgery.