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Methemalbumin in the Diagnosis of Acute Hemorrhagic Pancreatitis

MICHAEL C. GEOKAS, M.D., Ph.D.; HEINRICH RINDERKNECHT, Ph.D.; CLIFORD B. WALBERG, Ph.D.; and ROBERT WEISSMAN, M.D.
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▸Requests for reprints should be addressed to M. C. Geokas, M.D., Ph.D., Department of Medicine, Martinez VA Hospital, Martinez, CA 94553.


Ann Intern Med. 1974;81(4):483-486. doi:10.7326/0003-4819-81-4-483
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The early differentiation between acute edematous and hemorrhagic pancreatitis is crucial for prognosis and treatment. By testing serum and ascites or pleural effusion for methemalbumin the two types of pancreatitis can be distinguished early in the course of the disease. In a series of 18 patients with acute hemorrhagic pancreatitis we consistently found methemalbuminemia, whereas in 20 patients with severe edematous pancreatitis, five patients with gastrointestinal bleeding, and two patients with acute intraabdominal hemorrhage methemalbumin in serum was not found. The detection of methemalbumin in serum and ascites or pleural effusion of patients with a history and enzyme studies compatible with acute pancreatic inflammation should be considered virtually pathognomonic of the hemorrhagic form.

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