[Variable course in acute pancreatitis exemplified by case reports].

The variable clinical presentation and natural history of acute pancreatitis are illustrated by case reports, namely a case with a falsely positive diagnosis of biliary pancreatitis, a case with acute interstitial pancreatitis of biliary origin, a patient with early and severe late systemic complications and with sterile necrotizing pancreatitis necessitating operative debridements twice, a patient with acute pancreatogenic ascites and ARDS requiring drainage and respiratory supportive care, a patient with biliary pancreatitis and operation for necrotizing cholecystitis, with a further, late intervention for pancreatic abscess, and a patient with internal drainage for a pseudocyst, complicated by acute biliary pancreatitis due to cholesterolosis of the gallbladder. Modern clinico-pathological classification of acute pancreatitis and modern definitions of pancreatic sepsis are important for determining prognosis and adequate treatment.