On prognosis and treatment of acute severe pancreatitis with severe uremia

The prognosis of patients with acute pancreatitis and severe uremia is very poor. The mortality is nearly 80 per cent. In uremia requiring dialysis the mortality is 90 per cent in published materials. The slightly uremic patients, when dialysed, had a better prognosis than the severely uremic patients. The mortality in our material, consisting of cases usually dialysed at a late stage, was 100 per cent. Dialysis in these cases seems rather useless, considering the patients' severe cell damage caused by the toxic products emanating from the necrotic pancreas. It seems desirable to remove or depress the toxic focus surgically or by local irradiation as soon as possible. Attempts at a late stage to eliminate the toxic products from the pancreas and the abdominal cavity by peritoneal lavage or local radiation seem to have no effect.