A 40-year old male, obese, chronic alcoholic was admitted to the hospital with a diagnosis of "acute abdomen". Severe pain and tenderness started after a large meal which included a considerable amount of alcohol. The pain radiated over the entire abdomen and into the back.

Physical examination revealed a pulse rate of 120/minute. The blood pressure was 90/50 mmHg. He was wheezing and in apparent respiratory distress and was extremely apprehensive. The anterior abdominal wall was rigid and very tender to palpation.

Laboratory findings included increased amylase and lipase in the serum. The following day low serum calcium and glucosuria were found.

The patient was treated for shock but this was unsuccessful. The patient died on the third day of hospitalization.

Gross appearance of the pancreas. Can you identify areas of necrosis and hemorrhage? Is the process limited to pancreas or does it involve the surrounding fat tissue as well?

Gross appearance of the pancreas. Can you identify areas of necrosis and hemorrhage? Is the process limited to pancreas or does it involve the surrounding fat tissue as well?

In this case, in addition to the hemorrhage one can see extensive saponification of the fat tissue. Explain the nature of "saponification". Why is it white?

Gross appearance of a pseudocyst of pancreas.

Question for Class Discussion