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Shock or Coma as the Predominant Manifestation of Painless Acute Pancreatitis

A. H. TOFFLER, M.D.; and H. M. SPIRO, M.D.
Ann Intern Med. 1962;57(4):655-659. doi:10.7326/0003-4819-57-4-655
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Acute pancreatitis sometimes goes undetected when abdominal pain, persistent vomiting, or jaundice is absent. Although painless chronic pancreatitis has been well documented (1, 2), painless acute pancreatitis is much less frequently recognized. We have seen several patients in the past few years in whom the only manifestation of acute pancreatitis was shock. Review of autopsy records indicated that shock as the only manifestation of acute pancreatitis had not been noted before. It is the purpose of this report, therefore, to emphasize that shock or coma, appearing to result from a myocardial infarct, diabetic coma, or cerebrovascular accident, may be the


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