PANCREAS, DISEASES OF THE. In sclerosis, atrophy, acute and chronic inflammatory changes and new growths in the pancreas an absence or lessening of pancreatic secretion may be evident. Haemorrhage into the pancreas is of some medico-legal importance as being a cause of death. Acute haemorrhagic pancre atitis is a combination of inflammation with haemorrhage in which the pancreas is enlarged and infiltrated with blood. Violent pain, vomiting and collapse, are the chief features as is also the case in pancreatic abscess in which the abscess may be single or mul tiple. In the latter condition operation has been followed by recovery. Haemorrhagic inflammation has been followed by gangrene of the pancreas, which usually terminates fatally. In two remarkable cases, however, reported by Chiari recovery followed on the discharge per rectum of the necrosed pancreas. Chronic pancreatitis has been said by Mayo Robson to occur in connec tion with the symptoms of catarrhal jaundice, which he suggested is due to the pressure on the common duct by the swollen pan creatic tissue. The organ is enlarged and very hard, and the
symptoms are pain, dyspepsia, jaundice, loss of weight and the presence of fat in the stools. This latter sign is common to all forms of pancreatic disease. In connection with many pancreatic diseases small yellowish patches are found in the pancreatic tissue, mesentery, omentum and abdominal fatty tissue generally, and the tissues appear to be studded with whitish areas often not larger than a pin's head. The condition, which was first observed by Balser, has been termed "fat-necrosis," and is due to the action on the fat of lipolytic ferment set free by disorganization of the pancreas. The pancreas like other organs, is subject to the occur rence of new growths, tumours and cysts, syphilis and tubercu losis. Of these carcinoma of the head of the organ is the most common. Diabetes (q.v.) is the subject of a special article.