PANCREAS - Acute haemorrhagic pancreatitis

This shows the head and the body of the pancreas, cut somewhat obliquely; there is a rim of duodenal mucosa covering part of the head and body. There are a number of yellowish areas of necrosis, up to 1.5 cm. in diameter and, particularly towards the end of the specimen, there are many areas of haemorrhage. The chalky areas which can be distinguished towards the surface of the pancreas represent fat necrosis.
This man was admitted to hospital following sudden onset of acute abdominal pain. He was known to have a heavy alcohol intake, and had been treated for alcoholism. Prior to his admission, he had been drinking heavily. Serum amylase on admission was 8200 international units/litre; a laparotomy was carried out because it was thought that there was gas lying free in the abdomen. He died four days after admission and, at autopsy, this lesion was demonstrated; there was no fat necrosis apparent, and his liver showed severe fatty change.