J. Edward Berk, M.D.
JAMA. 1953;152(1):1-5. doi:10.1001/jama.1953.03690010007001.
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Although dissenting opinions continue to be expressed,1 the prevailing attitude today in the management of acute pancreatitis is one of conservatism.2 This paper is concerned with a basically conservative approach to the treatment of this disease, and it is intended to outline the principles underlying such an approach and to describe some of the means of attaining the objectives of the treatment. Except for suggestive differences in clinical severity and degree of chemical alterations, precise distinction between acute edematous or interstitial pancreatitis and acute hemorrhagic necrosis of the pancreas is impossible. The eventual progress of the disease cannot be accurately foretold when the patient is first seen. Hence, during the early phase of an acute attack, the seemingly mild case and the obviously severe one are treated as basically alike in this plan of management. Moreover, the basic treatment applied in cases of primary acute pancreatitis does not


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