We present a case of necrotising pancreatitis following ampullary biopsy in a patient with Barrett's oesophagus. The patient needed multiple necrosectomies and several admissions to the intensive care unit. This report is only the third and most severe case of pancreatitis following ampullary biopsy, highlighting its importance as a complication.

Problems facing the modern health care worker are examined. These include population changes, the changing pattern of disease, the psychosocial aspects of aging, and altered pathophysiologic mechanisms. The major future requirements in health care for the elderly are outlined. Greater emphasis should be placed upon education in the disciplines of Gerontology and Geriatric Medicine. Society needs to be made more aware of the realities of aging. Health care professionals need to develop their communication skills and to practice more effective teamwork. Greater coordination of the components of health care delivery systems will be needed in order to provide comprehensive and continuing health services. Research into the true and changing needs of the elderly recipients of health care should be emphasized. Prevention and early detection of disease is an important focus in Geriatric Medicine for the future.