Acute pancreatitis in Great Britain--a review.
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Biomedical subjects
Publications and source records attributed to J E Trapnell.
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Chronic relapsing pancreatitis in adolescence is a most uncommon clinical problem and has received minimal separate recognition in the literature. Adolescence is an age when the causes of the disease, which may operate from birth, overlap with the major etiological factors in the generality of pancreatitis in adult life. A personal series of 32 patients with pancreatitis, aged 11-20 years, is reported. Twenty-four followed a chronic relapsing course. There was, therefore, a marked reversal of the normal preponderance of acute over chronic relapsing cases. Those with underlying biliary disease, and the group in whom no etiological factors could be identified, ran an unexpectedly severe and troublesome course. This, coupled with the reversal of the acute versus chronic disease ratio, raises the question as to whether adolescent pancreatitis is a distinct subgroup in the overall spectrum of this disease.
Staging of cancer of the pancreas is relatively reliable when based on pathological material obtained from operative specimens or at autopsy. At operation, the assessment of disease stage, and therefore of operability, is more difficulty-particularly in relation to the extent of lymph node involvement and liver metastases. Preoperative staging, which, clinically, is the most essential, is difficult and unsatisfactory at the present time.
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