The necropsy findings in 3 patients who died between 4 and 14 weeks after episodes of acute pancreatitis are described. The most striking features were the extent of extraperitoneal necrosis and the comparative normality of residual portions of the pancreas. It is suggested that when the duct system is disrupted, the secretions of the surviving pancreas cause progressive enzymatic destruction of extrapancreatic tissues and thus contribute to the mortality of the disease.