Carlos de Barros Mott

Acute pancreatic necrosis in chronic alcoholic pancreatitis

Necrotic lesions are rarely observed in chronic pancreatitis, but its presence in a few patients has been misinterpreted in the diagnosis of acute pancreatitis. In this series, 12 patients (11.2%) of 107 operated for chronic alcoholic pancreatitis, presented with acute pancreatic necrosis associated with pancreatic fibrosis characteristic of chronic pancreatitis. Ten patients were treated by pancreatic debridement and drainage and two by distal pancreatic resections. Postoperative complications included five pancreatic fistulas and two pancreatic abscesses. Despite the severity of the pancreatic lesions which led to several complications, all the patients survived. The occurrence of pancreatic necrosis in patients with chronic pancreatitis is demonstrated.

Histologic and functional alterations of human exocrine pancreas in Manson's schistosomiasis

The exocrine pancreas of 20 patients with the hepatosplenic form of Mansons schistosomiasis and portal hypertension was examined. Surgical biopsies taken from the tail of the pancreatic gland during splenectomy and splenorenal shunts were examined histologically. Studied by the secretin test, peak bicarbonate concentrations in 16 of the 20 patients were below the lower critical statistical level; in 14 patients, marked histopathologic changes were found in the exocrine pancreas.