The histological features of 24 pancreases obtained from patients who died of causes other than
hepatitis,
pancreatitis or pancreatic
tumors, included a variable degree of
autolysis, rare foci of inflammatory reaction but no hemorrhagic
fat necrosis or destruction of elastic tissue in vessel walls (elastolysis). Assays of
elastase in extracts of these pancreases showed no free
enzyme, but varying amounts of
proelastase.A review of autopsy findings in 33 patients with fatal liver
necrosis attributed to
halothane anesthesia, demonstrated changes of
acute pancreatitis only in two. On the other hand, a review of 16 cases of fulminant viral
hepatitis revealed changes characteristic of
acute pancreatitis in seven - interstitial
edema, hemorrhagic
fat necrosis, inflammatory reaction and frequently elastolysis in vessel walls. Determination of
elastase in extracts of one pancreas showed the bulk of the
enzyme in free form. Furthermore, assays of urinary
amylase in 44 patients with viral
hepatitis showed increased levels of this
enzyme (2583 +/- 398 mean value +/- standard error, Somogyi units per 100 ml in 13, or 29.5 percent). The evidence suggests that
acute pancreatitis may at times complicate viral
hepatitis. Although direct proof of viral pancreatic involvement is not feasible at present, a rational hypothesis is advanced which underlines similar mechanisms of tissue involvement in both liver and pancreas that may be brought about by the hepatitis viruses.