| Compartment syndrome in experimental chronic obstructive pancreatitis: effect of decompressing the main pancreatic duct. | |
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MedLine Citation:
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PMID: 8156353 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Chronic pancreatitis is characterized by persistent and severe pain, which can be relieved by decompression of the main pancreatic duct (MPD). Both ductal and interstitial pressures have been shown to be increased in chronic pancreatitis in patients. A study was carried out of pancreatic interstitial pressure and pancreatic blood flow in normal cats and those in which chronic obstructive pancreatitis had been induced 5 weeks earlier to determine the effect of decompression of the MPD. In the normal pancreas, median(interquartile range (i.q.r.)) basal interstitial pressure was 0.05(1.2) mmHg and median(i.q.r.) basal pancreatic blood flow 58.3(24.3) ml per min per 100 g. Secretory stimulation did not change the interstitial pressure significantly, but was associated with a 40 per cent increase in median(i.q.r.) blood flow to 81.8(45.8) ml per min per 100 g. In contrast, in chronic obstructive pancreatitis, the median(i.q.r.) basal interstitial pressure was 2.0(1.5) mmHg, which was significantly higher than in the normal gland, and median(i.q.r.) pancreatic blood flow was 38.3(9.8) ml per min per 100 g, significantly lower than in the normal pancreas. Furthermore, secretory stimulation was associated with a significant increase in median(i.q.r.) interstitial pressure to 3.3(1.6) mmHg and a simultaneous decrease in median(i.q.r.) blood flow to 31.5(13.7) ml per min per 100 g. After decompression of the MPD in cats with chronic obstructive pancreatitis, the median(i.q.r.) basal interstitial pressure was 2.0(1.4) mmHg and on secretory stimulation 1.8(1.5) mmHg. Decompression thus prevented the increase in interstitial pressure seen in the animals with obstruction. In contrast, ductal decompression improved the median(i.q.r.) basal pancreatic blood flow to 45.9(38.4) ml per min per 100 g and, furthermore, this increased significantly on secretory stimulation to a median(i.q.r.) of 81.4(47.8) ml per min per 100 g. Decompression thus restored the normal pattern of secretory hyperaemia. Within the confines of this model, these observations demonstrate that chronic obstructive pancreatitis exhibits a compartment syndrome that is relieved by duct drainage. |
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Authors:
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N D Karanjia; A L Widdison; F Leung; C Alvarez; F J Lutrin; H A Reber |
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Publication Detail:
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Type: Journal Article; Research Support, U.S. Gov't, Non-P.H.S. |
Journal Detail:
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Title: The British journal of surgery Volume: 81 ISSN: 0007-1323 ISO Abbreviation: Br J Surg Publication Date: 1994 Feb |
Date Detail:
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Created Date: 1994-05-19 Completed Date: 1994-05-19 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0372553 Medline TA: Br J Surg Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 259-64 Citation Subset: AIM; IM |
Affiliation:
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Department of Surgery, Sepulveda Veterans' Affairs Medical Center, California. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Cats Compartment Syndromes / surgery Disease Models, Animal Female Male Pancreas / blood supply* Pancreatic Ducts / secretion, surgery* Pancreatitis / metabolism, surgery Pressure |
| Comments/Corrections | |
Comment In:
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Br J Surg. 1994 Oct;81(10):1541
[PMID:
7820497
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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