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目的：探讨致死性急性坏死性胰腺炎（ＡＮＰ）的临床特点及致死因素，以改善对此类病例的早期诊断和治疗。方法：复习和分析该院３０年２６例生前未能诊断的ＡＮＰ的临床及病理资料。结果：５０％患者为４０岁以下的男性患者，病程短骤，２２例死于起病２４小时内，其中８例为瞬间死亡。病理发现２６例均有胰腺坏死，２２例有胰腺出血；并肺充血及肺水肿者１４例；冠状动脉（冠脉）粥样斑块４例，其中１例有前壁心肌坏死破裂致心包积血，１例心肌陈旧性瘢痕，４例有心肌纤维断裂；中枢神经系统脱髓鞘病变１例；２例为胸腺淋巴体质，仅１例见胆囊结石及胆囊炎。结论：此组病例胰腺病变严重，但多数患者心脏病变并不很重甚至完全无改变，推测其猝死原因可能与胰腺急性坏死强烈刺激植物神经引起冠脉痉挛或严重心律失常有关。肺部充血及肺水肿也是造成ＡＮＰ病情急速恶化的重要因素。
Objective: To investigate the clinical features and lethal factors of fatal acute necrotizing pancreatitis (ANP) in order to improve the early diagnosis and treatment of such cases. Methods: To review and analyze the clinical and pathological data of 26 cases of ANP which had not been diagnosed in the past 30 years. RESULTS: Fifty percent of patients were men under 40 years of age with a short course of disease and 22 died within 24 hours of onset, of which 8 were instantaneous deaths. Pathological findings of 26 cases were pancreatic necrosis, pancreatic hemorrhage in 22 cases; pulmonary congestion and pulmonary edema in 14 cases; coronary artery (coronary) atherosclerotic plaque in 4 cases, 1 case of anterior myocardial necrosis caused by pericardial Blood, 1 case of old myocardial scar, 4 cases of myocardial fiber rupture; central nervous system demyelinating lesions in 1 case; 2 cases of thymic lymphoid constitution, only 1 case of gallbladder stones and cholecystitis. Conclusion: The pancreatic lesions in this group of patients are serious, but most of the patients with heart disease is not very heavy or even no change. It is speculated that the cause of sudden death may be related to acute necrosis of the pancreas and strongly stimulate the autonomic nerve to cause coronary spasm or severe arrhythmia. Pulmonary congestion and pulmonary edema are also important factors that contribute to the rapid deterioration of ANP.