Ischemic acute pancreatitis: clinical features of 11 patients and review of the literature.
BACKGROUND
Besides alcohol and gallstones, pancreatic ischemia can cause acute pancreatitis (AP). This entity should be considered when no other reasons can be defined. The aim of the current study was to define ischemic AP with its pathophysiologic, radiologic, and clinical conditions.


METHODS
Eleven patients with ischemic AP of different origin were analyzed regarding course, severity, and outcome, as well as diagnostic and therapeutic measures.


RESULTS
Ischemic AP was caused by hemorrhage and hypotension (7 patients) or mesenteric macrovessel occlusion (4 patients). Therapy was conservative (4 patients) or operative with hemostasis, necrosectomy, and drainage (7 patients). Seven patients died within 38 days, and 4 patients recovered.


CONCLUSIONS
Pancreatic hypoperfusion is an important etiology of AP. Severity of the disease ranges from moderate reversible changes to severe courses with fatal outcome. The indication for surgical intervention in ischemic AP is more aggressive; diagnostic and conservative therapeutic procedures are similar to AP of other etiologies.
Hackert
Thilo
T
Department of Surgery, University of Heidelberg, Heidelberg, Germany. Thilo_Hackert@med.uni-heidelberg.de
Hartwig
Werner
W
Fritz
Stefan
S
Schneider
Lutz
L
Strobel
Oliver
O
Werner
Jens
J
D000208:Acute Disease; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007511:Ischemia / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000098:blood supply* / Q000503:physiopathology; D010195:Pancreatitis / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy