Fulminant hepatitis complicated by pancreatitis

A 21 yr old male with hepatitis B antigen positive fulminant hepatitis had clinical and postmortem evidence of a complicating hemorrhagic pancreatitis. A review of 18 additional consecutive patients with fulminant hepatitis who died, revealed morphologic evidence of pancreatitis in 8 (44%). There was only 1 patient with pancreatitis (6%) in an age and sex matched control group. The increased incidence of pancreatitis in patients with severe hepatitis was not explained by the use of corticosteroid therapy or the presence of uremia. These observations suggest that pancreatitis may be a frequent accompaniment of fulminant hepatitis, presenting additional problems in management, especially in the maintenance of fluid balance.