title: Infected pancreatic necrosis increases the severity of experimental necrotizing pancreatitis in mice.
abstract: OBJECTIVE
  Infection of pancreatic necrosis in necrotizing pancreatitis increases the lethality of patients with acute pancreatitis. To examine mechanisms underlying this clinical observation, we developed and tested a model, in which primary infection of necrosis is achieved in taurocholate-induced pancreatitis in mice.
  
  
  METHODS
  Sterile necrosis of acute necrotizing pancreatitis was induced by retrograde injection of 4% taurocholate into the common bile duct of Balb/c mice. Primary infection of pancreatic necrosis was induced by coinjecting 10 colony-forming units of Escherichia coli. Animals were killed after 6, 12, 24, 48, and 120 hours, and pancreatic damage and pancreatitis-associated systemic inflammatory response were assessed.
  
  
  RESULTS
  Mice with pancreatic acinar cell necrosis had an increased bacterial concentration in all tissues and showed sustained bacteremia. Acute pancreatitis was induced only by coinjection of taurocholate and not by bacterial infection alone. Infection of pancreatic necrosis increased pancreatic damage and the pulmonary vascular leak. Serum glucose concentrations serving as a parameter of hepatic function were reduced in mice with infected pancreatic necrosis.
  
  
  CONCLUSIONS
  Primary infection of pancreatic necrosis with E. coli increases both pancreatic damage and pulmonary and hepatic complications in acute necrotizing pancreatitis in mice.
authors.affiliation: From the Department of General and Visceral Surgery, Universitätsklinik Freiburg, Freiburg, Germany.
authors.forename: Philipp J
authors.initials: PJ
authors.lastname: Poxleitner
authors.forename: Gabriel
authors.initials: G
authors.lastname: Seifert
authors.forename: Sabine C
authors.initials: SC
authors.lastname: Richter
authors.forename: Ulrich T
authors.initials: UT
authors.lastname: Hopt
authors.forename: Uwe A
authors.initials: UA
authors.lastname: Wittel
mesh_terms: D000818:Animals; D016470:Bacteremia / Q000382:microbiology / Q000473:pathology; D004195:Disease Models, Animal; D004927:Escherichia coli Infections / Q000382:microbiology / Q000473:pathology*; D008297:Male; D051379:Mice; D008807:Mice, Inbred BALB C; D009336:Necrosis; D019283:Pancreatitis, Acute Necrotizing / Q000382:microbiology* / Q000473:pathology*; D018746:Systemic Inflammatory Response Syndrome / Q000382:microbiology / Q000473:pathology