Multifocal myocardial necrosis and fibrosis in pancreatic diseases of children.

From a review of 2,000 autopsies of children, 16 cases of extensive 
necrosis and scarring fibrosis of the myocardium were found. These lesions 
involved mainly the left ventricle and spared the endocardium, the pericardium, 
and the coronary vessels. These necrotic of fibrotic heart lesions were 
found to be closely associated with various pancreatic diseases: cystic fibrosis 
(11 cases), pancreatic lipomatosis (2 cases), extensive small bowel resection (3 
cases, 2 of which were associated with acute interstitial pancreatitis). To 
explain these unexpected associations, two hypotheses can be put forth: (1) 
The lack of absorption of some presently undetermined substances indispensable for 
the correct trophicity of the myocardium, and (2) the release in 
the blood of proteolytic enzymes with consecutive activation of phlogistic substances 
such as kinins. 