Page 169 - Color Atlas Of Pathophysiology (S Silbernagl Et Al, Thieme 2000)

A. Causes and Consequences of Acute Pancreatitis
Alcohol etc.
Gallstones
Epithelial
permeability
raised
Enzymes
Reflux of
duodenal contents Protein-
(activated enzymes) plug
Bile Bile reflux
duct Pancreatic 3
duct 4 Enzyme diffusion,
2 protein precipitation Pancreatitis
1 Premature, Zymogen
Duodenum intracellular granules
Pressure increase enzyme activation Acute
5
7
6 Acute pancreatitis Autophagic
vacuole Plate 6.13
Lysosomes
Golgi
P P
E Acinar cell

Normal
Extracellular and/or intracelluar Autocatalysis
trypsin activation

Activation of:
Phospholipase A 2 Elastase Complement Prothrombin Kallikrein Systemic
damage
Bile Cell toxicity Thrombin Bradykinin,
kallidin
Fat Islet Vessel Thrombosis Vasodilation
necrosis necrosis arrosion and plasma
exudation

Hypalbu- Ca 2+ Insulin Bleeding Ischemia
minemia sequestration

Hyper- Pancreatic
Hypocalcemia glycemia gangrene Pain Shock Hypoxia Anuria 159
CTs from: Sleisenger, Fortran. Gastrointestinal Disease. 5th ed. Philadelphia: WBSaunders; 1993; Vol.2: 1641 (Supplied by E.T. Steward, M.D.)
Silbernagl/Lang, Color Atlas of Pathophysiology © 2000 Thieme
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