Summary
A vascular pathogenesis of pancreatitis has been postulated in diabetics, the aged, Ortner’s Syndrome, and various low-flow states. This report studies canine pancreatic secretion in a preparation of hypovolemic shock produced by controlled hemorrhage maintained for varying durations.
Pancreatic secretion was collected by cannulation of the main pancreatic duct in anesthetized dogs. Secretin was administered by continuous intravenous (i.v.) infusion of 4 U/kg/h. Four 15-min samples of pancreatic juice were collected. Then the dogs were bled by arterial line withdrawing 25–30% of total blood volume or until the mean blood pressure dropped to about 60 mmHg. Blood was collected in heparinized containers for reinfusion. Blood samples for amylase and 15-min samples of pancreatic juice for volume, bicarbonate, and enzymes were obtained during hypovolemia as well as during and following restoration of the blood volume.
Hypovolemia induced significant decreases in pancreatic flow, bicarbonate and amylase secretion, parameters which increased after reinfusion but never returned to pre-shock levels. Increasing the period of hypovolemia increased the inhibition of pancreatic flow, increased blood amylase elevation, and resulted in visible pancreatic edema.
We conclude that pancreatic secretion is diminished by hypovolemia, that this is initially reversible when hypovolemia is brief, but that the disturbance of function progresses to inflammatory pathology when hypovolemia is prolonged.
Similar content being viewed by others
References
Bor, N.M., The net insulin secretion and pancreatic blood flow in hypovolemia and in shock, New Istanbul Contrib. Clin. Sci., 1975; 11: 70–74.
Bor, N.M., Alvur, M., Erean, M.T. and Bebdik, CF., Pancreatic blood flow in hemorrhagic shock, Pflugers Arch., 1980; 386: 277–280.
Eichelter, P. and Schank, W.G., Hemodynamic of pancreatic secretion and pancreatic oxygen consumption, Arch. Surg., 1966; 93: 200–207.
Jones, R.T., Kreisberg, J.I., Linhardt, G.E. and Trump, B.F., Studies of the ischemic pancreas in shock, Adv. Shock Res., 1978; 1: 197–207.
Tankel, H. and Hollander, V., The relation between pancreatic secretion and local blood flow, Gastroenterology, 1957; 32: 633–641.
Preshaw, R.M., Cooke, A.R. and Grossman, M.I., Stimulation of pancreatic secretion by a chemical agent from the pyloric gland area of the stomach, Gastroenterology, 1965; 49: 617.
Barzilai, A., Ryback, B.J., Medina, J.A., Lewis, T., Dreiling, D.A., Morphological changes of the pancreas in hypovolemic shock and the effect of pretreatment with steroids, Int. J. Pancreatol., 1986; 1: 000–000.
Delaney, J.P. and Grim, E., Influence of hormones and drugs on canine pancreatic blood flow, Am. J. Physiol., 1966; 211: 1398–1402.
Aune, S. and Semb, L.S., The effect of secretin of pancreozymin on pancreatic blood flow in the conscious and anesthetized dog, Acta Physiol. Scand., 1969; 76: 406–414.
Jones, R.T., Garcia, J.H., Mergner, W.J. and Trump, B.F., Effect of shock on the pancreatic acinar cell, Arch. Pathol., 1975; 99: 634–644.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Barzilai, A., Medina, J.A., Toth, L. et al. The effect of hypovolemic shock on pancreatic secretion. Int J Pancreatol 1, 373–379 (1986). https://doi.org/10.1007/BF02801869
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02801869