Elderly people with pancreatitis black stools are considered to be caused by upper gastrointestinal bleeding or physiological factors. Acute pancreatitis is a disease in which pancreatic enzymes are activated in the pancreas due to a variety of etiological factors causing auto-digestion, edema, hemorrhage and even necrosis of pancreatic tissues, which is mainly manifested by inflammatory reactions, with or without functional changes in other organs. Clinically, it is characterized by acute epigastric pain, nausea, vomiting, fever and increased blood pancreatic enzymes, and imaging shows swelling, exudation and necrosis of pancreatic tissue. 1. Upper gastrointestinal bleeding: pancreatitis is a systemic disease, showing systemic inflammatory reaction, causing serious damage to several organs of the patient’s body, pancreatic necrosis and hemorrhage, blood flowing into the duodenum along the pancreatic ducts to vomit coffee-colored material and black stool. At the same time, acute hemorrhagic necrotizing pancreatitis combined with stress ulcers can also cause acute gastric mucosal lesions bleeding. 2 Physiological factors: such as patients taking related drugs, food will also appear black stool, such as iron, bismuth potassium citrate, animal liver and so on. There is no special treatment at this time. Therefore, pancreatitis patients appear to have a black stool situation shows that the condition is more serious, it is recommended that the patient timely to the regular hospital to improve the relevant examination, a clear diagnosis.