Abstract A limited number of case reports have appeared in the literature which describe a beneficial response following the treatment of acute pancreatitis with adrenocorticosteroids.4,6,9-13,16,19 The exact mechanism responsible for this improvement is not known; however, prevention of circulatory failure5-7 and anti-inflammatory,8,9,13,17 antienzymatic,16 and antiallergic13 effects have been suggested. Included in the present study are two case reports of documented acute pancreatitis following abdominal operations. Both patients recovered after institution of abrenocorticosteroid therapy in conjunction with other supportive measures. Report of Cases Case 1. —A 47-year-old white woman was hospitalized on July 28, 1954, with a four-week history of cramping right-side abdominal pain, nausea, vomiting, and frequent eructations. Abnormal physical findings included a blood pressure of 210/110 and a firm, movable mass, 4 cm. in diameter, in the right midabdomen. Routine studies of blood and urine were within normal limits. Colon x-rays revealed a napkin-ring deformity References 1. Veterinary Nembutal sodium contains per cubic centimeter 60 mg. of pentobarbital sodium, 10% alcohol, and 20% propylene glycol in water. 2. The trypsin solution was prepared by mixing crystalline lyophilized trypsin (Tryptar) with 25 cc. of a sterile phosphate buffer solution. This resulted in a trypsin solution with 10,000 units per cubic milliliter. 3. Adams, T. W., and Musselman, M. M.: Pancreatic Venous Thrombosis as an Etiologic Factor in Acute Necrotizing Hemorrhagic Pancreatitis , S. Forum 4:401, 1953. 4. Anderson, M. C.; Van Hagen, F.; Method, H. L., and Mehn, W. H.: An Evaluation of the Use of Bile, Bile Salts, and Trypsin in the Production of Experimental Pancreatitis , Surg. Gynec. & Obst. 107:693, 1958. 5. Block, M. A.; Wakim, K. G., and Baggenstoss, A. H.: Experimental Studies Concerning Factors in the Pathogenesis of Acute Pancreatitis , Surg. Gynec. & Obst. 99:83, 1954. 6. Bloodworth, A. F., and Cohen, S. L.: Cortisone in Treatment of Acute Pancreatitis Associated with Mumps: Epidemic Parotitis , U. S. Armed Forces M. J. 7:285, 1956. 7. Bockus, H. L.; Kaiser, M. H.; Roth, J. L. A.; Bogoch, A. L., and Stein, G.: Clinical Features of Acute Inflammation of the Pancreas , A. M. A. Arch. Int. Med. 96:308, 1955. 8. Brockis, J. G., and Jones, E. T.: Treatment of Acute Hæmorrhagic Pancreatitis with Cortisone , Brit. M. J. 2:1524, 1956. 9. Comfort, M. W.: Treatment of Pancreatitis , A.M. A. Arch. Int. Med. 95:735, 1955. 10. Elman, R.: Discussion of Symposium on Pancreatitis , Gastroenterology , 28:588, 1955. 11. Eskwith, I. S.; Cacace, V. A., and Sollosy, A.: Acute Hemorrhagic Pancreatitis: Treatment with Cortisone , New England J. Med. 252:494, 1955. 12. Hoste, O.: Effects of Cortisone (Adrenocortical Preparation) Therapy in Pancreatitis During Infectious Hepatitis: Case , Belg. tijdschr. geneesk. 9:492, 1953. 13. Jones, C. A.: Medical Management of Acute Pancreatitis , A. M. A. Arch. Int. Med. 96:332, 1955. 14. Kaplan, M. H.: Acute and Chronic Relapsing Pancreatitis: The Clinical Implications of Their Acceptance as Diseases of Adaptation , Am. J. Gastroenterol. 25:234, 1956. 15. Moucliet, A., and Albahary, C.: Pancréatite aiguë hémorragique et hormones corticotropes , Presse méd. 63:706, 1955. 16. Nemir, P., Jr., and Drabkin, D. L.: The Pathogenesis of Acute Necrotizing Hemorrhagic Pancreatitis: An Experimental Study , Surgery 40:171, 1956. 17. Popper, H. L.; Necheles, H., and Russell, K. C.: Transition of Pancreatic Edema into Pancreatic Necrosis , Surg. Gynec. & Obst. 87:79, 1948. 18. Rogers, N. C.; Wilson, A. O.; Meynell, M. J., and Cooke, W. T.: Treatment of Acute Pancreatitis with Cortisone , Lancet 2:651, 1956. 19. Solem, J. H.; Knutrud, O., and Andresen, K. R.: Treatment of Acute Pancreatitis with Cortico-Depot , Acta chir. scandinav. 109:415, 1955. 20. Smyth, C. J.: Etiology of Acute Hemorrhagic Pancreatitis with Special Reference to Vascular Factors: An Analysis of Autopsies and an Experimental Investigation , Arch. Path. 30:651, 1940. 21. Stephenson, H. E., Jr.; Pfeffer, R. B., and Saypol, G. M.: Acute Hemorrhagic Pancreatitis: Report of a Case with Cortisone Treatment , A. M. A. Arch. Surg. 65:307, 1952.
A.M.A. Archives Surgery – American Medical Association
Published: May 1, 1959