{"id":2342,"date":"2025-03-14T16:18:45","date_gmt":"2025-03-14T20:18:45","guid":{"rendered":"https:\/\/wordpress.forensicpath.us\/?p=2342"},"modified":"2025-03-15T07:41:06","modified_gmt":"2025-03-15T11:41:06","slug":"pathology-cases-acute-necrotizing-pancreatitis","status":"publish","type":"post","link":"https:\/\/wordpress.forensicpath.us\/index.php\/2025\/03\/14\/pathology-cases-acute-necrotizing-pancreatitis\/","title":{"rendered":"Pathology cases — acute necrotizing pancreatitis"},"content":{"rendered":"

A 50 year old woman complained of a six day history of increasing abdominal pain.\u00a0 She was found unresponsive in bed by her husband.\u00a0 At autopsy, she had a vitreous glucose of 900 mg\/dL and just a teeny bit of acetone.\u00a0 Examination of the gallbladder revealed no bile, but it was sclerosed around two large smooth pale green stones, measuring 1.8 and 2.2 cm respectively.\u00a0 Examination of the pancreas revealed it to be necrotic and hemorrhagic with a 3 cm hemorrhagic cyst near the tail.\u00a0 \u00a0There was a sharp demarcation between remaining relatively normal pancreas and the large area of necrosis:<\/p>\n

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On histologic examination, there were broad areas of coagulative necrosis and necrobiosis, with a mixed acute and chronic inflammatory cell infiltrate (mostly mononuclear).\u00a0 The splenic artery was thrombosed.<\/p>\n

Here’s the panorama pic.\u00a0 The remnant of viable pancreatic tissue is on the right:<\/p>\n

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Here’s a closer view with the viable pancreas on the right:<\/p>\n

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A thrombosed vessel:<\/p>\n

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Some fat necrosis in the surrounding adipose tissue:<\/p>\n

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Examination of the gallbladder revealed chronic cholecystitis:<\/p>\n

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While I found stones in the gallbladder, I didn’t find anything in the ducts.\u00a0 \u00a0That doesn’t bother me.\u00a0 With over a week of symptoms, she may well have passed it once the pancreatitis started snowballing.\u00a0 About 80 percent of acute necrotizing pancreatitis comes from either gallstones or alcohol use.\u00a0 There was no alcohol use in this case.<\/p>\n

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A 50 year old woman complained of a six day history of increasing abdominal pain.\u00a0 She was found unresponsive in…<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[99,108,109,1],"tags":[59,116,28],"class_list":["post-2342","post","type-post","status-publish","format-standard","hentry","category-forensic-pathology","category-gross-pathology","category-pathology-cases","category-uncategorized","tag-autopsy","tag-pancreas","tag-pathology"],"_links":{"self":[{"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/posts\/2342","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/comments?post=2342"}],"version-history":[{"count":1,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/posts\/2342\/revisions"}],"predecessor-version":[{"id":2353,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/posts\/2342\/revisions\/2353"}],"wp:attachment":[{"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/media?parent=2342"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/categories?post=2342"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/tags?post=2342"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}