Clinical and morphologic comparison of pancreatic damage in acute destructive pancreatitis

Aim. To compare structural changes revealed at autopsy with clinical data, allowing to clinically predict the pancreatic damage in patients with acute destructive pancreatitis. Methods. Case histories and post-mortem pancreatic tissue samples from 12 patients who died of acute destructive pancreatitis, were examined. Results. Autopsies revealed the similar frequency of pancreatic anterior and posterior surface damage. Three types of pancreatic damage were observed: (1) total or extensive necrosis - 5 cases; (2) pancreatic fatty degeneration - 3 cases; (3) inflammatory changes with local necrotic lesions - 4 cases. Pancreatic morphologic changes were matched with clinical data and results of laboratory and instrumental tests that were performed in the patients who died from pancreatitis. The most significant clinical and laboratory changes were seen in patients with extensive necrosis, while in patients with pancreatic fatty degeneration and local necrotic lesions clinical presentations and changes in laboratory and instrumental tests were not so severe. Conclusion. Macro- and microscopic changes in pancreas observed in patients with acute destructive pancreatitis can be characterized as total or extensive necrosis, pancreatic fatty degeneration and acute inflammation with local necrotic lesions; matching the clinical and morphologic data revealed the relation between the extent of the pancreatic damage and clinical severity of acute destructive pancreatitis.

pancreas, acute pancreatitis, pancreonecrosis, hystotopogram, clinical and morphologic matching