Routes of spread of pathogens into the pancreas in a feline model of acute pancreatitis.
The routes of spread of pathogens into the pancreas in acute pancreatitis were investigated. Four experiments were performed: (1) cats with and without acute pancreatitis were given 10(7) Escherichia coli (E coli) intravenously, (2) in cats with acute pancreatitis 10(8) E coli was placed in the colon. In half of them the colon was then enclosed in an impermeable bag to prevent transmural spread. (3) E coli (10(4)) was placed in the pancreatic duct in cats with and without acute pancreatitis. (4) In cats with acute pancreatitis 10(5) E coli was placed in the gall bladder. In half of them the common bile duct was ligated to prevent biliary-pancreatic reflux. After 24 hours, intravenous E coli infected the pancreas in six of nine cats with acute pancreatitis and three of 10 controls. After 72 hours E coli spread to the pancreas from the colon in six of nine cats with acute pancreatitis. This was prevented by enclosing the colon in an impermeable bag (p = 0.02). In five of six cats with acute pancreatitis and five of six controls E coli placed in the pancreatic duct colonised the pancreas within 24 hours. Pancreatic colonisation from the gall bladder occurred in five of six cats with a patent common bile duct and in three of six with an obstructed common bile duct. In conclusion, in cats E coli can spread to the pancreas by the blood stream, transmurally from the colon, and by reflux into the pancreatic duct.
Department of Surgery, VA Medical Center, Sepulveda, California.
A L
AL
Widdison
N D
ND
Karanjia
H A
HA
Reber
D000208:Acute Disease; D000818:Animals; D001655:Bile Reflux / Q000382:microbiology; D002415:Cats; D003092:Colitis / Q000382:microbiology; D003106:Colon / Q000382:microbiology; D004195:Disease Models, Animal; D004927:Escherichia coli Infections / Q000382:microbiology*; D010179:Pancreas / Q000382:microbiology*; D010195:Pancreatitis / Q000382:microbiology*