Abstract

Systemic complications including pancreatitis associated lung injury are the main predominators for the outcome of severe pancreatitis. The aim of the present study was to evaluate whether pulmonary complications in acute pancreatitis are more likely to develop in alcoholics, and whether cytokine release and microcirculation of the liver play a pathophysiological role. MethodsAfter feeding rats with either LieberdeCarli a) control diet (CD) or b) alcohol diet (AD) for 6 weeks, an experimental severe pancreatitis was induced (CD-SP and AD-SP; n = 12/group). Control animals received Ringers solution i.v. (CD-C and AD-C). Intravital microscopy of the pancreas and liver were performed at 6hrs and pancreatic, liver and lung injury were evaluated at 12 hrs. Cytokines were evaluated in portal and systemic blood. ResultsPancreatic injury was not increased by AD-C compared to CD-Co Moreover, pancreatic microcirculatory disturbances and pancreatic injury were not different between AD-SP and CD-SP, but lung injury was more pronounced in AD-SP. The microcirculation of the liver was changed by both alcohol diet alone and acute pancreatitis alone, but was even more disturbed in alcoholic rats. IL-6 levels were significantly elevated in CD-SP, and even more in AD-SP. Systemic levels of IL-6 were significantly higher than in the portal blood. ConclusionAlcoholic pancreatitis is associated with a significant more severe lung injury than biliary disease. Pronounced disturbances of the liver microcirculation in alcoholic rats seem to induce a higher hepatic release of cytokines, and by that may trigger pancreatitis associated lung injury.