title: Pathogenesis of pancreatic encephalopathy in severe acute pancreatitis.
abstract: BACKGROUND
  Pancreatic encephalopathy (PE) is a serious complication of severe acute pancreatitis (SAP). In recent years, more and more PE cases have been reported worldwide, and the onset PE in the early stage was regarded as a poor prognosis sign of SAP, but the pathogenesis of PE in SAP still has not been clarified in the past decade. The purpose of this review is to elucidate the possible pathogenesis of PE in SAP.
  
  
  METHODS
  The English-language literature concerning PE in this review came from the Database of MEDLINE (period of 1991-2005), and the keywords of severe acute pancreatitis and pancreatic encephalopathy were used in the searching.
  
  
  RESULTS
  Many factors were involved in the pathogenesis of PE in SAP. Pancreatin activation, excessive release of cytokines and oxygen free radicals, microcirculation abnormalities of hemodynamic disturbance, ET-1/NO ratio, hypoxemia, bacterial infection, water and electrolyte imbalance, and vitamin B1 deficiency participated in the development of PE in SAP.
  
  
  CONCLUSIONS
  The pathogenesis of PE in SAP has not yet been fully understood. The development of PE in SAP may be a multi-factor process. To find out the possible inducing factor is essential to the clinical management of PE in SAP.
authors: Department of General Surgery, Hangzhou First People's Hospital, Hangzhou, China. zxp99688@vip.163.com
authors: Xi-Ping
authors: XP
authors: Zhang
authors: Hua
authors: H
authors: Tian
mesh_terms: D000208:Acute Disease; D000818:Animals; D001927:Brain Diseases / Q000209:etiology* / Q000503:physiopathology; D016207:Cytokines / Q000097:blood; D019332:Endothelin-1 / Q000097:blood; D006801:Humans; D000860:Hypoxia / Q000209:etiology / Q000503:physiopathology; D009569:Nitric Oxide / Q000097:blood; D010194:Pancreatin / Q000502:physiology; D010195:Pancreatitis / Q000150:complications* / Q000503:physiopathology; D013832:Thiamine Deficiency / Q000209:etiology
chemical_list: D016207:Cytokines; D019332:Endothelin-1; D009569:Nitric Oxide; D010194:Pancreatin