Bile exclusion from the gut exacerbates acute pancreatitis caused by pancreatic duct obstruction in rats.
Acute pancreatic duct obstruction causes hyperamylasemia and mild pancreatic inflammation. We hypothesized that bile exclusion from the gut, which stimulates pancreatic secretion, exacerbates acute pancreatitis caused by pancreatic duct obstruction. Rats were surgically prepared with gastric, duodenal, bile, and pancreatic fistula catheters and a jugular vein catheter. After a 4-day recovery, groups of rats (a) served as controls, (b) had complete pancreatic duct obstruction for 6 h, or (c) had bile excluded from the gut for 24 h and then, during the final 6 h, complete pancreatic duct obstruction. Plasma amylase was measured, and all rats were euthanized at the end of experiments. Each pancreas was excised and weighed, and portions were fixed in formalin and glutaraldehyde. In blind fashion, each pancreas was examined under light microscopy and assigned a pancreatitis score based on presence of edema and severity of acinar cell changes and inflammation. Acute pancreatic duct obstruction was associated with increased pancreas weight, hyperamylasemia, and elevated pancreatitis score; moderate acinar cell vacuoles, which were observed in the cytoplasm near the basolateral membrane, and loss of microvilli were noted with electron microscopy. Bile exclusion from the gut exacerbated the acute pancreatitis caused by pancreatic duct obstruction; acinar cell distortion and destruction, as well as marked inflammation, were seen microscopically. These observations suggest that the absence of intestinal bile contributes to the pathogenesis of acute pancreatitis associated with pancreatic duct obstruction.
Murayama
K M
KM
Surgical and Research Service, VA Lakeside Medical Center, Chicago, IL 60611.
Drew
J B
JB
Yokoo
H
H
Joehl
R J
RJ
D000208:Acute Disease; D000681:Amylases / Q000097:blood; D000818:Animals; D001646:Bile / Q000502:physiology*; D007422:Intestines / Q000502:physiology*; D008854:Microscopy, Electron; D010183:Pancreatic Ducts / Q000502:physiology*; D010195:Pancreatitis / Q000209:etiology* / Q000503:physiopathology; D051381:Rats
D000681:Amylases