Introduction One of the most frequent and dangerous complications of destructive pancreatitis is the affect of the retroperitoneal parapancreatic cellular tissue. The term parapancreatitis is often used to define it. Researchers distinguish four main forms of parapancreatitis: serous, serohemorrhagic, infiltrative-necrotic and pussy-putride.

Goal. To reveal morphostructural changes in the pancreas and target organs most characteristic for various forms of parapancreatitis.

Materials and methods. Study conducted retrospective analysis of 203 autopsy protocols of patients who died from acute pancreatitis (K.85) and chronic pancreatitis with outcome in pancreatic necrosis (K.86), who were treated in the surgical departments and intensive care and resuscitation departments of the Minsk city for 2015–2019.

Results. In our study, there were 2 forms of parapancreatitis: serohemorrhagic in 18 (8.9%) cases and infiltrative-necrotic in 185 (91.1%) cases. Study examined the structure of complications of destructive pancreatitis, combined with various forms of parapancreatitis. Study examined morphostructural changes in target organs (liver, kidneys, heart, lungs) for various forms of parapancreatitis.

Conclusions. Infiltrative-necrotic parapancreatitis occurred at a latest stages of the disease than serohemorrhagic. Fibrinopurulent peritonitis and multiple organ failure are statistically significantly more common complications in infiltrative-necrotic parapancreatitis in comparison with serohemorrhagic. The rate of neutrophilic infiltration of the hepatic lobules in the liver tissue is statistically significantly higher for infiltrative-necrotic parapancreatitis in comparison with serohemorrhagic, and frequency of fibrotic and atrophic changes in the pancreatic tissue is higher. For other morphostructural changes in the liver tissue and also in the tissues of the kidneys, lungs and myocardium there were no differences between different forms of parapancreatitis.

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