[Biliary sepsis: some peculiarities of pathogenesis].
Results of clinical study of 87 biliary sepsis patients and experimental study on 54 rats with obstructive jaundice and cholangitis are presented. Own and literary data are compared. Specific immune and portal haemodynamic changes, provoced by obstructive jaundice are main pathogenic factors defining specific course of biliary sepsis. These changes are: 1) gut bacterial and endotoxin translocation, portal endotoxaemia; 2) reduction of RES and Kupfer cell function and endotoxin break into the systemic circulation; 3) liver parenchyma ischemia and milliary abscess formation; 4) portal blood flow shunting into the general circulation additionally increasing systemic endotoxaemia. These factors determine rapid, even fulminate development of milliary abscesses of the liver and multiorganic failure. The authors suggest that etiologic and pathogenic factors, causing peculiarities of the clinical course should be indicated in the diagnosis of septic patient.
Gal'perin
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Akhaladze
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D000818:Animals; D001402:B-Lymphocytes / Q000276:immunology; D001419:Bacteria / Q000302:isolation & purification; D001424:Bacterial Infections / Q000209:etiology / Q000276:immunology / Q000382:microbiology; D002761:Cholangitis / Q000150:complications* / Q000276:immunology / Q000382:microbiology; D019446:Endotoxemia / Q000276:immunology / Q000382:microbiology; D005260:Female; D006801:Humans; D008099:Liver / Q000098:blood supply; D008102:Liver Circulation; D008297:Male; D008875:Middle Aged; D051381:Rats; D012189:Retrospective Studies; D018805:Sepsis / Q000209:etiology* / Q000276:immunology / Q000382:microbiology; D013601:T-Lymphocytes / Q000276:immunology