6. Acute pancreatitis – adiponecrosis

Last updated on January 17, 2019 at 16:50

Staining: HE

Organ: Pancreas


We can see normal acinar cells. There are paler areas showing necrosis. We can also see neutrophils and RBCs.

Diagnosis: Acute pancreatitis with adiponecrosis


Acute pancreatitis occurs when there is a blockage of the pancreatic duct, causing congestion that leads to pancreatic enzymes being activated inside the pancreatic parenchyme. These activated enzymes will then digest the pancreas, causing an acute inflammation.

Causes for pancreatic duct blockage can be:

  • Bile stone
  • Alcohol abuse (activates Oddi sphincter constriction, viscous pancreatitic secretion)
  • Hypercalcemia
  • Hyperlipidemia
  • Chemotherapy
  • Tumor

Acute pancreatitis has two phases. The first is the edematous phase and the second phase is the haemorrhagic phase. 80% of cases stop in the first phase, however it is the second phase that is life-threatening. It can cause sepsis, cardiac failure and ARDS, the latter of which can cause respiratory failure.

Neutrophils are present because there is an acute inflammation, while the RBCs shows that this slide is from the haemorrhagic phase of acute pancreatitis. The RBCs are released from the vessels as the vessels are digested by the pancreatic enzymes.

I wasn’t in the class when we went through this slide, so I don’t really know the detailsSorry.

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