Acute pancreatic necrosis is a term usually applied to a serious, often fatal, disease of the pancreas which is due to autodigestion of the gland, presumably by activation within the ducts of trypsinogen to trypsin, the latter being a powerful proteolytic ferment. The classic observations of Fitz,1 based on necropsy study, have long been the basis for physicians' knowledge of this remarkable condition. The mortality is very high even if operation is carried out, although it has been generally agreed that the disease is primarily surgical and that surgical intervention offers the greatest hope of survival.
For the past decade or so a growing experience has shown that many patients with acute pancreatitis are cured without operation and that many are cured even if nothing more than exploration is done at operation. According to this point of view, acute pancreatitis tends to become less and less a surgical disease,