Pancreatic ischemia associated with vasospasm in the early phase of human acute necrotizing pancreatitis

Kazunori Takeda, Yukio Mikami, Shoji Fukuyama, Shinichi Egawa, Makoto Sunamura, Tadashi Ishibashi, Akihiro Sato, Atsushi Masamune, Seiki Matsuno

Research output: Contribution to journalArticlepeer-review

86 Citations (Scopus)

Abstract

Objectives: The angiographic appearance of acute necrotizing pancreatitis (ANP) demonstrates ischemic change with vasospasm in and around the pancreas. We investigated the role of vasospasm in pancreatic ischemia and necrosis in the early phase of human ANP. Methods: The relationship between the angiographic abnormalities and the perfusion status of the pancreas documented by contrast-enhanced computed tomography (CE-CT) was examined in 102 patients with ANP who were admitted during the early phase of the disease. Results: Ischemic change with vasospasm on angiography of the intrapancreatic and extrapancreatic arteries was observed and corresponded with the poorly perfused area of the pancreas detected by CE-CT done at admission. Resultant pancreatic necrosis was confirmed on follow-up CE-CT examination consistent with the location where angiography demonstrated ischemic change with vasospasm. Severe ischemic change on angiography was primarily observed in patients in whom more than 50% of the pancreas was poorly perfused. The extent of the ischemic change was correlated with the extent of the poorly perfused area of the pancreas and the mortality rate. Conclusion: These results suggest that vasospasm is involved in the development of pancreatic ischemia and necrosis in the early phase of ANP.

Original languageEnglish
Pages (from-to)40-49
Number of pages10
JournalPancreas
Volume30
Issue number1
Publication statusPublished - 2005 Jan

Keywords

  • Acute pancreatitis
  • Ischemic change
  • Vasospasm

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Endocrinology

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