J.Jpn. Surg. Soc.. 81(9): 944-948, 1980
Report on the annual meeting
PATHOPHYSIOLOGY OF ACUTE PANCREATITIS
－CHANGES OF SERUM PANCREATIC ENZYME LEVELS AND HEMODYNAMICS－
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First Department of Surgery, Osaka City University Medical School Katsusuke Satake, Yoshaku Tei, Keishoku Cho, Shigehiko Nishimura, Kaoru Umeyama |
During both experimental and clinical acute pancreatitis, serum elastase levels decreased and serum trypsin levels did not increase significantly by enzymatic methods.
On the other hand, serum elastase and trypsin levels increased significantly by radioimmunoassay.
It is suggested the measurements of serum elastase and trypsin levels are good methods to diagnose acute pancreatitis.
II) Hemodynamic changes and blood coagulation during experimental pancreatitis were examined.
Hypovolemic shock was observed during acute pancreatitis. The causes of hypovolemic shock was mainly decreased total blood volume due to plasma loss. Bradykinin, increased in blood, has a major role for this plasma loss especially plasma albumin loss.
The changes of hemodynamics were the decrements of cardiac output and stroke volume. Although these cardiac dysfunctions were caused by hypovolemia, M.D.F., found in ascitic fluid, may have one of these causes.
Decreased platelet counts and fibrinogen levels, prolonged prothrombin time and P.T.T., shortened E.L.T. and increased F.D.P. were observed. Multiple microembolies were also observed in the lung and the kidney, which indicate D.I.C..
These pathophysiological changes are important to understand acute pancreatits.
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