title: Ischemic acute pancreatitis: clinical features of 11 patients and review of the literature.
abstract: 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.
authors.affiliation: Department of Surgery, University of Heidelberg, Heidelberg, Germany. Thilo_Hackert@med.uni-heidelberg.de
authors.forename: Thilo
authors.initials: T
authors.lastname: Hackert
authors.forename: Werner
authors.initials: W
authors.lastname: Hartwig
authors.forename: Stefan
authors.initials: S
authors.lastname: Fritz
authors.forename: Lutz
authors.initials: L
authors.lastname: Schneider
authors.forename: Oliver
authors.initials: O
authors.lastname: Strobel
authors.forename: Jens
authors.initials: J
authors.lastname: Werner
mesh_terms: 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