Acute pancreatitis: A historical perspective

Among the various pancreatic disorders, the pace of scientific discovery in acute pancreatitis has been particularly slow. The objective of this paper was to briefly review the history of scientific discovery of the clinical features, pathophysiology, and treatment of acute pancreatitis. A clinical description of acute pancreatitis was first presented in 1652 by the Dutch anatomist Nicholas Tulp, and despite the nearly 350 years that have passed, there continue to be many unanswered questions. In the late 19th and early 20th century, Reginald Fitz, Nicholas Senn, Eugene Opie, and others made seminal contributions that continue to influence our present understanding of acute pancreatitis. Despite remarkable progress in the past 6 decades, our ability to accurately diagnose and estimate the severity of acute pancreatitis remains limited. History provides multiple examples of empiric remedies and surgical interventions based on the prevailing theories and opinions of the scientific luminaries du jour, and indeed, after 3 centuries of inquiry, the most effective interventions for acute pancreatitis are purely supportive in nature and not specific to the pancreas. However, the perseverance of successive generations of the finest scientific minds provides hope that we will unravel the many mysteries of this enigmatic gland.