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On Proving Therapeutic Effectiveness in Acute Pancreatitis

Eddy D. Palmer, MD
JAMA. 1974;229(1):73. doi:10.1001/jama.1974.03230390049028.
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Clinicians are likely to agree that among abdominal diseases none displays a diversity of clinical features to equal that of acute pancreatitis. Both the subjective and objective spectrums are so broad that the clinician, however experienced, regularly hesitates to make the diagnosis on the clinical manifestations alone. He prefers to await laboratory confirmation by demonstration of increased circulating amylase and lipase activity. (see communication by Katz et al on p 47). As a consequence, acute pancreatitis is a particularly interesting disease on the ward and a most difficult one to handle in an investigational setting. Assessment of the precise usefulness of any one of the several therapeutic moves ordinarily employed for management of the acute stage becomes almost impossible.

The present-day therapeutic potpourri for acute pancreatitis has become "standard" because each of its components makes sense when one considers what we know of the disease's pathophysiology. Thus, we know there


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