Case 1, image 1: This 47 year old man had stigmata of chronic alcohol use including steatosis and cirrhosis of the liver and acute hemorrhagic pancreatitis. Sections of pancreas demonstrate fat necrosis, hemorrhage and sheets of infiltrating neutrophilis, destruction of the acini and ducts including islets of Langerhans.
Case 1, image 2: Parts of the pancreas are autolyzed, however, necrosis, inflammation and hemorrhage can still be in seen.
Case 1, image 3: In better preserved areas, hemorrhage and inflammation can still be clearly discerned.
Case 2, image 1: This was a 79 year old male who died of hemorrhagic pancreatitis due to chronic alcoholism. Although again, there is quite a bit of autolysis, you can see fresh hemorrhage.
Case 2, image 2: Blood actually shows up pretty well histologically even though at autopsy, you make not sure if the dark fluid is truly blood or decomposition.
Case 2, image 3: Even though the cells are breaking down, you can still see that there is a mixed inflammatory infiltrate.
In a study of 27 cases of death due to pancreatitis, 19 cases were attributed to alcoholism and 2 cases were due to gallstones. The remainder were had other causes or were idiopathic. Complications included lung edema and/or acute respiratory distress syndrome, peritonitis, disseminated intravascular coagulation, and sepsis (Tsokos, 2007).
Tsokos M, Braun C. Acute pancreatitis presenting as sudden, unexpected death: an autopsy-based study of 27 cases. Am J Forensic Med Pathol. 2007 Sep;28(3):267-70.