Abstract
A three-dimensional reconstruction of the pancreatic ducts has been made from the secondary branches of the main duct to the terminal acini. This has been carried out by cutting serial sections from surgical specimens of the pancreas from 10 patients with alcoholic calcifying chronic pancreatitis, specimens from 2 patients with a small carcinoma obstructing the main pancreatic duct, and a normal pancreas. The lesions of calcifying pancreatitis demonstrated by this method showed characteristically: (a) spotty distribution of the lesions which were related to the ducts; (b) a frequent finding in the ducts of plugs of precipitated protein, which tended to evolve into calculi by deposition of calcium on their surface (these plugs rarely contained mucopolysaccharide); (c) all sizes of duct were involved and showed irregular dilation, loss of lining epithelium, encroachment of periductal connective tissue to form stenosis, pancreatic cysts or complete disappearance of acini, and ducts in the territory drained by a blocked duct. In chronic pancreatitis secondary to an obstruction in the main pancreatic duct, the lesions are different in almost every respect from those described above.
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