Abstract SINCE THE first comprehensive study of acute pancreatitis made by Fitz 1 in 1889, most descriptions of the disease cite pain as the outstanding symptom.2-15 Only recently has attention been drawn to certain unusual forms of pancreatitis without pain,16 and in at least two studies mention is made of acute painless pancreatitis.17,18 The purpose of this communication is to report two such cases studied in the course of the last seven years. Report of Cases Case 1. —A 22-year-old white man was hospitalized in December 1956 for tonsillectomy. Past history revealed only tonsillitis in the preceding five years. His alcoholic intake was moderate and occasional. He denied previous symptoms attributable to the digestive tract. Physical examination was normal, showing only undernourishment, and all the laboratory studies were normal.On Dec 11, 1956, tonsillectomy was performed with local anesthesia. The immediate postoperative course was uneventful. The patient was References 1. References 3, 4, 8, 11, 13, 20, and 21. 2. Fitz, R.H.: Acute Pancreatitis: A Consideration of Pancreatic Hemorrhage, Hemorrhagic, Suppurative and Gangrenous Pancreatitis and Disseminated Fat Necrosis , Boston M. & S. J. 120:181, 225, 1889. 3. Cattell, R.B., and Warren, K.W.: Surgery of the Pancreas , Philadelphia: W. B. Saunders Co., 1953, p 64. 4. Dozzi, D.L., and Bockus, H.L.: "Acute Pancreatitis, Pancreatic Injuries and Pancreatic Fistula," in Bockus, H. L.: Gastro Enterology , Philadelphia: W. B. Saunders Co., 1946, vol 3, p 774. 5. Kowlessar, O.D.: " Diseases of the Pancreas ," in Beeson, P. B., and McDermott, W.: Cecil-Loeb Textbook of Medicine , ed 11, Philadelphia: W. B. Saunders Co., 1963, p 943. 6. Palmer, E.D.: Clinical Gastroenterology , New York: Hoeber-Harper, 1957, p 578. 7. Ingelfinger, F.J.: " Diseases of the Pancreas ," in Principles of Internal Medicine , ed 3, T. R. Harrison, (ed.), New York: McGraw-Hill Book Co., Inc., 1958, p 1476. 8. Wollaeger, E.E.: " Clinical Diagnosis and Management of Pancreatitis and Pancreatic Carcinoma ," in G. McHardy: Current Gastroenterology , New York: Hoeber-Harper, 1962, p 468. 9. Jones, F.A., and Gummer, J.W.P.: Clinical Gastroenterology , Springfield, Ill: Charles C Thomas, Publisher, 1960, p 511. 10. Richman, A.: Acute Pancreatitis , Amer J Med 21:246, 1956. 11. Bockus, H.L., et al: Clinical Features of Acute Inflammation of the Pancreas , Arch Intern Med 96:308, 1955. 12. Aaron, A.H., and Milch, E.: Acute Pancreatitis , Med Clin North America 40:451, 1956. 13. Bockus, H.L.: Acute Inflammation of the Pancreas , Gastroenterology 34:467, 1958. 14. Farrar, J.T.: Pancreatitis, Medical Aspects , Med Clin North America 38:1393, 1954. 15. Heffernon, E.W., and Cassiet, A.C.: A Survey of Acute Hemorrhagic Pancreatitis , Lahey Clin Bull 11:23, 1958. 16. Priestley, J.T.: Pancreatitis , Surg Clin North America 37:953, 1957. 17. Bartholomew, L.G., and Comfort, W.B.: Chronic Pancreatitis Without Pain , Gastroenterology 31:727, 1956. 18. Poshi, R.A.; Probstein, J.G.; and Blumenthal, H.T.: A Survey of Experiences with Three Hundred Clinical and One Hundred and Eight Autopsy Cases of Acute Pancreatitis , Amer Surg 23:34, 1957. 19. Bartholomew, L.G.: Newer Concepts in Pancreatic Disease , Gastroenterology 36:122, 1959. 20. Popper, H.: The Pathological Aspects of Pancreatic Disease , Rev Gastroenterol 19:183, 1952. 21. Child, C.C.: " Acute Pancreatitis ," in Cecil, R.L., and Loeb, R.E.: A Textbook of Medicare , ed 9, Philadelphia: W. B. Saunders Co., 1955, p 964. 22. Anderson, A.F.R.: Office Gastroenterology , Philadelphia: W. B. Saunders Co., 1958, p 591. 23. Paxton, J.R., and Payne, J.H.: Acute Pancreatitis: A Statistical Review of 307 Established Cases of Acute Pancreatitis , Surg Gynec Obstet 86:69, 1948. 24. Fallis, L.S., and Plain, G.: Acute Pancreatitis; Report of 26 Cases , Surgery 5:358, 1939.
Archives of Internal Medicine – American Medical Association
Published: Dec 1, 1965
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