Pancreatic Blood Flow and Contrast Enhancement in Computed Tomography during Experimental Pancreatitis

Schröder, T; Kivisaari, Leena; Standertskjöld‐Nordenstam, C.‐G.; Somer, K; Lehtola, A.; Puolakkainen, Pauli; Karonen, S.-L.; Kivilaakso, Eero; Lempinen, M

doi:10.1159/000128480

Cited by 21 publications

(3 citation statements)

References 2 publications

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“…These changes do not appear to be homogeneous, with ischaemia and stasis in the areas of most severe disease8, 38, 76, 84 and vasodilatation or hyperaemia in areas of relative sparing9. There is no correlation between total pancreatic blood flow and regional pancreatic perfusion85. Pathological shunting causes significant alterations to tissue oxygenation61 and the proportion increases with progression of acute pancreatitis61.…”

Section: Vascular Effects Of Acute Pancreatitismentioning

confidence: 99%

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Disturbances of the microcirculation in acute pancreatitis

Cuthbertson

Christophi

2006

British Journal of Surgery

251

172

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Section: Vascular Effects Of Acute Pancreatitismentioning

confidence: 99%

“…Somatostatin infusion has both beneficial and deleterious effects, depending on the animal model studied80, 85. Animals in these studies were not recovered to assess effects on survival.…”

Section: Therapies For Microvascular Derangement In Acute Pancreatitismentioning

confidence: 99%

Disturbances of the microcirculation in acute pancreatitis

Cuthbertson

Christophi

2006

British Journal of Surgery

251

172

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“…During acute pancreatitis, microvascular perfusion is altered in accordance to the severity of the disease [36] , and regional macrohemodynamic blood flow appears not to correlate with microcir culation [37] . Pancreatic blood flow, red cell velocity, and functional capillary density all decrease; end artery vasoconstriction and increased shunts lead to ischemia, necrosis and circulatory stasis [38] .…”

Section: Pancreatic Microcirculation and Acute Pancreatitismentioning

confidence: 98%

Thoracic epidural anesthesia: Effects on splanchnic circulation and implications in Anesthesia and Intensive care

Siniscalchi

Gamberini

Laici

et al. 2015

WJCCM

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AIM:To evaluate the currently available evidence on thoracic epidural anesthesia effects on splanchnic macro and microcirculation, in physiologic and pathologic conditions. METHODS:A PubMed search was conducted using the MeSH database. Anesthesia, Epidural was always the first MeSH heading and was combined by boolean operator AND with the following headings: Circulation, Splanchnic; Intestines; Pancreas and Pancreatitis; Liver Function Tests. EMBASE, Cochrane library, ClinicalTrials. gov and clinicaltrialsregister.eu were also searched using the same terms. RESULTS:Twenty-seven relevant studies and four ongoing trials were found. The data regarding the effects of epidural anesthesia on splanchnic perfusion are conflicting. The studies focusing on regional macro-hemodynamics in healthy animals and humans undergoing elective surgery, demonstrated no influence or worsening of regional perfusion in patients receiving thoracic epidural anesthesia (TEA). On the other hand most of the studies focusing on micro-hemodynamics, especially in pathologic low flow conditions, suggested that TEA could foster microcirculation. CONCLUSION:The available studies in this field are heterogeneous and the results conflicting, thus it is difficult to draw decisive conclusions. However there is increasing evidence deriving from animal studies, that thoracic epidural blockade could have an important role in modifying tissue microperfusion and protecting microcirculatory weak units from ischemic damage, regardless of the effects on macro-hemodynamics.

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Contrast-enhanced abdominal computed tomography scanning and prediction of severity of acute pancreatitis: A prospective study

London

Neoptolemos

Lavelle

et al. 1989

Journal of British Surgery

101

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One hundred and fifty-two patients were admitted to a single hospital with a diagnosis of acute pancreatitis during a 31-month period. Of these, 126 patients had contrast-enhanced abdominal computed tomography (CT) scans within 72 h of admission; 92 of these attacks were clinically mild, 34 were clinically severe. A single consultant radiologist reported the scans 'blind' and noted whether pancreatic enhancement was normal, increased or decreased, and whether there was loss of peripancreatic tissue planes. The maximum anteroposterior measurement of the pancreatic head and body were multiplied together to produce a 'pancreatic size index' (cm2). Significantly more patients with severe attacks had decreased pancreatic enhancement (79 versus 58 per cent, P = 0.01) and loss of peripancreatic tissue planes (82 versus 54 per cent, P = 0.006). The median (range) pancreatic size index for clinically severe attacks was 12.8 cm2 (3.0-52.5), and for mild attacks was 6.0 cm2 (1.1-23.4), P less than 0.0001. Modified Glasgow criteria had a sensitivity of 85 per cent and specificity of 79 per cent for clinically severe attacks. A pancreatic size index of greater than or equal to 10 cm2 had a sensitivity of 71 per cent and specificity of 77 per cent for clinically severe attacks. In conclusion, although there were highly significant differences between the clinically severe and mild groups with respect to pancreatic enhancement, peripancreatic tissue planes and pancreatic size indices, these CT criteria did not improve on modified Glasgow criteria for prediction of disease severity.

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Pancreatic Blood Flow and Contrast Enhancement in Computed Tomography during Experimental Pancreatitis

Cited by 21 publications

References 2 publications

Disturbances of the microcirculation in acute pancreatitis

Disturbances of the microcirculation in acute pancreatitis

Thoracic epidural anesthesia: Effects on splanchnic circulation and implications in Anesthesia and Intensive care

Contrast-enhanced abdominal computed tomography scanning and prediction of severity of acute pancreatitis: A prospective study

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