Acute pancreatitis : a consideration of pancreatic hemorrhage, hemorrhagic, suppurative, and gangrenous pancreatitis, and of disseminated fat-necrosis / by Reginald H. Fitz.

  • Reginald Heber Fitz
Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: Acute pancreatitis : a consideration of pancreatic hemorrhage, hemorrhagic, suppurative, and gangrenous pancreatitis, and of disseminated fat-necrosis / by Reginald H. Fitz. Source: Wellcome Collection.

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    with fine granules. These were enormous granu- lar corpuscles, which, from their size and shape, were regarded as identical with fat-cells. There were also narrow and elongated, fatty-degenerated cells, so disintegrated in many places as to form a finely granular detritus. Ponfick attributed these spots of necrosis to a fatty degeneration of the marrow. Balser,° who became an assistant of Ponfick, then professor at Gottingen, found similar appear- ances in the marrow and in the subpericardial fat, each in an old man. In the examination of twenty- five unselected cases he found such patches in the region of the pancreas, in five instances. Two of these patients died of cancer of the stomach, and the remaining three were cases of pulmonary'con- sumption, hepatic cirrhosis, and aortic endocarditis respectively. There remain two additional cases in which he found fat-necrosis.^ These he regarded as illustrative of the fatal effect of a disease, fat-necrosis, which, when exten- sive, was associated with old and fresh hemor- rhage. Such hemorrhages near the pancreas might produce death in the manner resembling that described by Zenker as pancreatic apoplexy. He regarded the fat-necrosis as the result an excessive growth of fat-tissue which destroyed the tissue It surrounded. Prom its association it was a special source of danger to fat persons His conclusion is:i°2 An excessive growth of the fat cells near the pancreas occurs in many men It may become so excessive, in very fat people, that a large part of the abdominal fat dies, and it thus proves fatal, either on account of the quantity destroyed or the associated hemorrhage Chiari3 had also found fat-necrosis associated with pancreatic disease,* although in his published report he made no note of the characteristic appear- ances. He confirmed Balser's statements concerning the occurrence of fat-necrosis in and near the pan 'ooXoc. cit. 'o' No8. XXIV., LXVII.