Acute pancreatitis—Pathophysiology and therapy

Research paper by Koichi Ishikawa, Yoshio Tajima, Akira Kuroda, Yukio Ishihara, Nagao Sato

Indexed on: 01 Jun '71Published on: 01 Jun '71Published in: The Japanese journal of surgery


We presented the following two concepts which will simplify the interpretation of a vast body of data and concepts about pathogenetic mechanism of acute pancreatitis.Under physiological conditions, various defensive factors within the pancreas may inhibit activation of pancreatic enzymes and prevent excessive leakage and retention of pancreatic juice into the interstitial space and then protect the pancreatic parenchyma against injurious actions of pancreatic enzymes. A number of triggering factors such as bile reflux may break down the equillibrium between these agressive and defensive factors in favor of aggression, and thereby acute pancreatitis will be initiated.The process of acute pancreatis, furthermore, may be aggravated by complicated chain reactions through the mediation of pancreatic enzymes. The chain reactions are assumed to consist of 4 pathological cycles, i.e., autolytic, autodigestive, local vascular, and shock cycles.From these viewpoints, principle of therapy of acute pancreatitis was recommended.