Acute pancreatitis historical perspective

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]


Overview

Dutch physician and anatomist, Nicholaes Tulp in the year 1652 gave the first clear description of acute pancreatitis. The first systemic analysis of acute pancreatitis was presented by Reginald Huber Fitz in 1889. During the 20th century many theories were proposed with regards to whether surgery is to be preferred as the initial approach to the treatment of acute pancreatitis. Hans Chiari in 1896 proposed that the basic mechanism of the disease was autodigestion of pancreas. The father of modern anatomical pathology, Giovanni Battista Morgagni gave the first description of pancreatic pseudocysts.

Historical Perspective

The historical landmarks in the diagnostic evaluation and management of acute pancreatitis are as follows:[1] [2]

  • In 1642, Johannes Wirsung of Padua first described the pancreatic duct and the concept of the pancreas as a secretory organ.
  • In 1737, Giovanni Santorini of Venice identified a second, accessory duct and was credited with primacy in the discovery of the ampulla of Vater.
  • In 1887, Rugero Oddi published his observations of the structure and function of the choledochal sphincter in Archives Italiennes de Biologie that laid the basis for understanding its role in pancreatic and biliary disease.
  • In the 16th century, Sylvius Franciscus de la Boe Sylvius found that the pancreas discharged a fluid that mixed with the partly digested food and bile in the intestine causing an effervescence ("effervescentia intestinalis") which liquefied food.
  • In the 16th century, Regnier de Graaf of Delft devised novel surgical techniques to create pancreatic fistulas (center) to collect this juice for analysis.
  • In 1652, Nicholaes Tulp of Amsterdam is credited with the first description of acute pancreatitis.
  • In 1761, Giovanni Morgagni described the clinical syndrome of severe upper abdominal pain, vomiting, and collapse (acute pancreatitis). He is also credited with the earliest pathological recognition of cancer of the pancreas.
  • In 1652, Nicholaes Tulp was credited with the first description of acute pancreatitis
  • In 1842, Karl von Rokitansky, the premier pathologist of Vienna (Wiener Allgemeines Krankenhaus) was the first one to recognize acute hemorrhagic pancreatitis.
  • In late 18th century, Reginald Fitz described 3 forms of acute pancreatitis (hemorrhagic, suppurative, and gangrenous) and proposed that fat necrosis was a sequel of severe pancreatitis
  • In late 18th century, Nicholas Senn of Chicago, not only addressed the mechanisms of acute pancreatitis but also provided rational insight into the validity of surgical techniques for its treatment.

References

  1. Pannala R, Kidd M, Modlin IM (2009). "Acute pancreatitis: a historical perspective". Pancreas. 38 (4): 355–66. doi:10.1097/MPA.0b013e318199161c. PMID 19390402.
  2. Fitz, Reginald H. (1889). "Acute Pancreatitis". The Boston Medical and Surgical Journal. 120 (8): 181–187. doi:10.1056/NEJM188902211200801. ISSN 0096-6762.




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