Effects of ischemia on the human pancreas

Gullo, Lucio; Cavicchi, Lisa; Tomassetti, Paola; Spagnolo, C.; Freyrie, Antonio; D'Addato, M

doi:10.1016/s0016-5085(96)70072-0

Cited by 87 publications

(71 citation statements)

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“…Perioperative risk factors for postoperative ischemic pancreatitis are valve procedures (especially reoperations), myocardial infarction, bleeding, arrhythmias, low cardiac output, and need for vasopressors or intra-aortic balloon pump augmentation [11, 28]. Prolonged cardiopulmonary bypass also is a risk factor [11, 28, 146], presumably related to reduced cardiac output which shunts blood from the splanchnic circulation to areas of higher priority, such as the brain [147]. Most likely, hypotension and low cardiac output that occur after cardiopulmonary bypass are responsible for the ischemic insult rather than the cardiopulmonary bypass itself.…”

Section: Clinical Ischemia/reperfusion-induced Pancreatitismentioning

confidence: 99%

Ischemia/Reperfusion-Induced Pancreatitis

Sakorafas

Tsiotos

Sarr³

2000

Dig Surg

101

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Background/Aim: The pancreas is an organ highly susceptible to ischemic damage. This discussion reviews the role of ischemia as an etiologic factor in acute pancreatitis. Methods: Literature review. Results: The susceptibility of the pancreas to ischemia/reperfusion injury has been demonstrated in experimental studies and in clinical settings such as cardiopulmonary bypass, hemorrhagic shock, and transplantation of the pancreas. Oxygen free radicals, activation of polymorphonuclear leukocytes, failure of microvascular perfusion, cellular acidosis, and disturbance of intracellular homeostasis appear to be important factors/mechanisms in the pathogenesis of ischemia/reperfusion-induced acute pancreatitis. In clinical practice, the diagnosis of ischemic pancreatitis is difficult and often delayed, especially during the postoperative period after cardiac or major vascular surgery. Conclusions: Ischemia appears to be one important factor in acute pancreatitis. The management of ischemic pancreatitis is similar to that of acute pancreatitis of any etiology.

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Section: Clinical Ischemia/reperfusion-induced Pancreatitismentioning

confidence: 99%

Ischemia/Reperfusion-Induced Pancreatitis

Sakorafas

Tsiotos

Sarr³

2000

Dig Surg

101

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“…Shock, vascular occlusion in mesenteric vessels, cardiac arrest and cardiovascular surgery may lead acute ischemic pancreatitis (Gullo et al, 1996;Sakorafas et al, 2000;Piton et al, 2008;Drissi et al, 2009;Hackert et al, 2009;Piton et al, 2010). Ischemic AP frequency is estimated between 5% to 8% in literature (Warshaw and O'Hara, 1978;Sakorafas et al, 2000).…”

Section: Discussionmentioning

confidence: 99%

Silent ischemic pancreatitis following urosepsis

Aktaş

Duran²,

Alçelik³

et al. 2013

jecm

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Article HistoryReceived 24 / 04 / 2012 Accepted 09 / 05 / 2012Pancreatic ischemia is an uncommon cause of acute pancreatitis. Ischemia with resultant pancreatitis has been reported in vasculitis, atheroembolism, intraoperative hypotension, survivors of cardiac arrest and hemorrhagic shock. Ischemic acute pancreatitis is difficult to recognize clinically. In this report we present a 63 year old woman with painless ischemic pancreatitis following urosepsis. We suggest that if a critically ill patient is hypotensive for more than 24-48 hours, amylase levels must be monitored to establish ischemic acute pancreatitis (AP) even if the patient remains asymptomatic.

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“…[10][11][12] Since Panum [13] presented the first report, other researchers have reported that the pancreas is highly sensitive to ischemia. [14][15][16][17][18] In humans, acute pancreatitis may develop after embolic closure of the vessels supplying the pancreas, [19] after hypoperfusion of the pancreas during cardiac surgery [20,21] and surgery for thoraco-abdominal aneurysms, [22] after splanchnic hypoperfusion, [23] or after pancreatic transplantation. [24] We found that during 12 hours after admission, serum amylase concentrations were elevated, whereas serum lipase concentrations were below the upper reference limit, suggesting that hyperamylasemia is of non-pancreatic origin.…”

Section: Discussionmentioning

confidence: 99%

Is the pancreas affected in patients with septic shock? — a prospective study

Pezzilli

Barassi

Imbrogno

et al. 2011

Hepatobiliary & Pancreatic Diseases International

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BACKGROUND: Hyperamylasemia can be observed anecdotally during the course of severe sepsis or septic shock. This study aimed to investigate the possibility of pancreatic involvement in patients with septic shock using serum pancreatic enzyme determinations and imaging techniques in 21 consecutive patients with septic shock and 21 healthy subjects as controls. METHODS:The serum activity of pancreatic amylase and lipase was assayed initially in all subjects and 24 and 48 hours after the initial observation in the 21 patients with septic shock. All patients also underwent radiological examination to detect pancreatic abnormalities. RESULTS:The serum activity of pancreatic amylase was significantly higher in the 21 patients with septic shock than in the 21 control subjects during the study period, while the serum activity of lipase was similar to that of the control subjects. Amylase and lipase serum activity did not significantly changed throughout the study period in the 21 patients with septic shock. None of the patients with pancreatic hyperenzymemia had clinical signs or morphological alterations compatible with acute pancreatitis. CONCLUSION:The presence of pancreatic hyperenzymemia in septic shock patients is not a biochemical manifestation of acute pancreatic damage, and the management of these patients should be dependent on the clinical situation and not merely the biochemical results.

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Effects of ischemia on the human pancreas

Cited by 87 publications

References 0 publications

Ischemia/Reperfusion-Induced Pancreatitis

Ischemia/Reperfusion-Induced Pancreatitis

Silent ischemic pancreatitis following urosepsis

Is the pancreas affected in patients with septic shock? — a prospective study

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