INTERSTITIAL PANCREATITIS.
Causes: paresis, marasmus, septic infection, blood diseases. Lesions: connective tissue in excess—pancreas and liver; catarrhal complications; calcic points; congestion and petechiæ in septic infection. Areas of fat necrosis in the pancreas and abdominal adipose tissue. Stearates of lime. Calcic foci in animals. Symptoms: obscure. Treatment.
This is especially liable to accompany paretic and wasting diseases, septic infection, and diseases of the blood. Radionow examined the pancreas in animals that had suffered from chronic paralysis, gastro-intestinal catarrh, hepatic catarrh, chronic anæmia and marasmus, and found fatty degeneration of the epithelium, with atrophy and pigmentary degeneration of the glandular epithelium. The fibrous tissue of the gland was in excess in the pancreas and in the liver (sclerosis), and mucous cysts were found.
Siedamgrotzky found a chronic interstitial pancreatitis connected with alopecia, œdema and leucocythæmia. The pancreas was indurated, fibrous, resisting the edge of the knife and sprinkled with gritty particles. Much of the glandular tissue had been destroyed, and the ducts were filled with a dense, grayish, grumous mucus.
Kirilow and Stalnikow have found interstitial pancreatitis marked by congestion and ecchymosis, with intervening anæmic areas, in animals injected with septic matter. There was increased secretion in the early stages.
A marked feature of pancreatitis in man is the occurrence in the interlobular tissue of the gland, the omentum, mesentery and abdominal fatty tissue generally, of circumscribed areas of fat necrosis, each varying in size from a pin’s head upward even to a hen’s egg. On section these show a soft tallowy consistency and Langerhans has shown that they are composed of lime and fatty acids in combination. When lime is in excess they become gritty. According to Osler they may be dependent on some other primary affection (Bright’s disease). The partially calcified concretions found in the pancreatic ducts, and the yellowish white, gritty areas, which represent the degenerate lobules in animals (Seidamgrotzky) are suggestive of a similar morbid condition of the pancreas or it may be of some distant organ. Of late years a number of cases have been recorded in man and a very high mortality noted.
The symptoms in the lower animals are very obscure, and an accurate diagnosis is looked upon as almost impossible. They are essentially the same as given above under catarrhal pancreatitis.
Treatment too has the same narrow limitations.