RT Journal
A1 Machella TE
T1 MEdical aspects of pancreatitis
JF Journal of the American Medical Association
JO Journal of the American Medical Association
YR 1959
FD April 4
VO 169
IS 14
SP 1571
OP 1577
DO 10.1001/jama.1959.03000310023004
UL http://dx.doi.org/10.1001/jama.1959.03000310023004
AB The diagnosis of acute pancreatitis usually depends on the finding of a high serum amylase level in a patient with acute severe epigastric pain, abdominal tenderness, vomiting, fever, tachycardia, and leukocytosis. Increasingly exact methods of diagnosis have led to increasingly conservative methods of treatment. Therapy includes continuous aspiration of gastric contents, parenteral administration of solutions to preserve the water-electrolyte balance and combat shock, and use of antibiotics. The treatment must be adapted to the case, and surgery may be necessary. Chronic pancreatitis is usually seen in older patients after repeated attacks of acute pancreatitis, or during the progress of tuberculosis, syphilis, or hemochromatosis. Laboratory studies of the blood, especially determinations of pancreatic enzyme levels and glucose tolerance, are important in diagnosis. Chronic pancreatitis leads to diabetes, steatorrhea, and calcification, with the possibility of sudden fatal complications. Treatment is designed to eliminate, if possible, the cause of recurrences and to compensate, by means of insulin, pancreatin, and diet, for the loss of the internal and external secretions of the pancreas.