Intestinal Effects of Pancreatitis: Spread Along Mesenteric Planes

  • Morton A. Meyers


Acute inflammation of the pancreas may be classified into four groups:
  1. 1.

    Acute edematous pancreatitis is the most common form; there is localized or diffuse swelling of the organ.

  2. 2.

    Acute hemorrhagic pancreatitis is caused by the digestive effects of liberated trypsin and elastase on pancreatic vessels. The first changes caused by this vascular necrosis are found in the outer layer but the damage usually progresses rapidly to involve the entire thickness of the vessel wall, with disruption of the intima.1

  3. 3.

    Acute gangrenous pancreatitis is rare because of the rich vascularization of the pancreas.

  4. 4.

    Acute suppurative pancreatitis secondary to superimposed infection may range from a localized pancreatic abscess to diffuse involvement, perhaps as a gas—producing process.



Acute Pancreatitis Transverse Colon Splenic Flexure Pancreatic Pseudocyst Hepatic Flexure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Rich AR, Duff GI: Experimental and pathologic studies on pathogenesis of acute hemorrhagic pancreatitis. Bull Johns Hopkins Hosp 58: 212–259, 1936Google Scholar
  2. 2.
    Meyers MA, Evans JA: Effects of pancreatitis on the small bowel and colon: Spread along mesenteric planes. AJR 119: 151–165, 1973CrossRefGoogle Scholar
  3. 3.
    Mendez G, Isikoff MB, Hill MC: CT of acute pancreatitis: Interim assessment. AJR 135: 463–469, 1980PubMedCrossRefGoogle Scholar
  4. 4.
    Jeffrey RB, Federle MP, Laing FC: Computed tomography of mesenteric involvement in fulminant pancreatitis. Radiology 147: 185–188, 1983PubMedGoogle Scholar
  5. 5.
    Meyers MA, Oliphant M, Berne AS, et al: The peritoneal ligaments and mesenteries : Pathways of intra—abdominal spread of disease. Annual Oration. Radiology. 163: 593–604, 1987PubMedGoogle Scholar
  6. 6.
    Waring HJ, Griffiths HE: Acute pancreatitis. Br J Surg 11: 476–490, 1924CrossRefGoogle Scholar
  7. 7.
    Meyers MA, Whalen JP: Roentgen significance of duodenocolic relationships: Anatomic approach. AJR Rad Ther Nucl Med 117: 263–274, 1973CrossRefGoogle Scholar
  8. 8.
    Meyers MA: Roentgen significance of the phrenicocolic ligament. Radiology 95: 539–545, 1970PubMedGoogle Scholar
  9. 9.
    Aronson AR, Davis DA: Obstruction near hepatic flexure in pancreatitis: Rarely reported sign. JAMA 176: 133–134, 1961CrossRefGoogle Scholar
  10. 10.
    Price CWR: “Colon cut—off sign” in acute pancreatitis. Med J Australia 1: 313–314, 1956Google Scholar
  11. 11.
    Stuart C: Acute pancreatitis: Preliminary investigation of new radiodiagnostic sign. J Fac Radiologists 8: 50–58, 1956PubMedCrossRefGoogle Scholar
  12. 12.
    Brascho DJ, Reynolds TN, Zanca P: Radiographic “colon cut—off sign” in acute pancreatitis. Radiology 79: 763–768, 1962PubMedGoogle Scholar
  13. 13.
    Forlini E: Stenosi del colon da pancreatitis. Gior Clin Med 8: 609–620, 1927Google Scholar
  14. 14.
    L’Hermine C, Pringot J, Monnier JP, et al: Le retentissement colique des pancréatites: A propos de 39 observations. J Radiol 61: 27–34, 1980PubMedGoogle Scholar
  15. 15.
    Mohuiddin S, Sakiyalak P, Gullick HD, et al: Stenosing lesions of the colon secondary to pancreatitis. Arch Surg 102: 229–231, 1971CrossRefGoogle Scholar
  16. 16.
    Remington JH, Mayo CW, Dockerty MB: Stenosis of colon secondary to chronic pancreatitis. Proc Staff Meet Mayo Clin 22: 260–264, 1947PubMedGoogle Scholar
  17. 17.
    Thompson WM, Kelvin FM, Rice RP: Inflammation and necrosis of the transverse colon secondary to pancreatitis. AJR 128: 943–948, 1977PubMedCrossRefGoogle Scholar
  18. 18.
    Schwartz S, Nadelhaft J: Simulation of colonic obstruction at splenic flexure by pancreatitis: Roentgen features. AJR Ther Nucl Med 78: 607–616, 1957Google Scholar
  19. 19.
    Hunt DR, Mildenhall P: Etiology of strictures of the colon associated with pancreatitis. Am J Dig Dis 20: 941–946, 1975PubMedCrossRefGoogle Scholar
  20. 20.
    Meyers MA, Volberg F, Katzen B, et al: Haustral anatomy and pathology: A new look. II. Roentgen interpretation of pathologic alterations. Radiology 108: 505–512, 1973PubMedGoogle Scholar
  21. 21.
    Berne TV, Edmondson HA: Colonic fistulization due to pancreatitis. Am J Surg 111: 359–363, 1966PubMedCrossRefGoogle Scholar
  22. 22.
    Bohlman TW, Katon RM, Lee TG, et al: Use of endoscopic retrograde cholangiopancreatography in the diagnosis of pancreatic fistula: A case report and review of the literature. Gastroenterology 70: 582–584, 1976.PubMedGoogle Scholar
  23. 23.
    Clements JL, Jr, Bradley EL III, Eaton SB Jr: Spontaneous internal drainage of pancreatic pseudocysts. AJR 126: 985–991, 1976PubMedCrossRefGoogle Scholar
  24. 24.
    Alexander ES, Clark RA, Federle MP: Pancreatic gas: Indication of pancreatic fistula. AJR 139: 1089–1093, 1982PubMedCrossRefGoogle Scholar
  25. 25.
    Salvo AF, Nematolahi H: Distant dissection of a pancreatic pseudocyst into the right groin. Am J Surg 126: 430–432, 1973PubMedCrossRefGoogle Scholar
  26. 26.
    Strax R, Tooms BD, Rauschkolb EN: Correlation of barium enema and CT in acute pancreatitis. AJR 136: 1219–1220, 1981PubMedCrossRefGoogle Scholar
  27. 27.
    Warshaw AL: Inflammatory masses following acute pancreatitis. Phlegmon, pseudocyst, and abscess. Surg Clin N Am 54: 621–636, 1974PubMedGoogle Scholar
  28. 28.
    Simon M, Lerner MA: Duodenal compression by mesenteric root in acute pancreatitis and inflammatory conditions of bowel. Radiology 79: 75–80, 1962PubMedGoogle Scholar
  29. 29.
    Boijsen E, Tylen U: Vascular changes in chronic pancreatitis. Acta Radiol Diagn 12: 34–38, 1972Google Scholar
  30. 30.
    Walter JF, Chuang VP, Bookstein JJ, et al: Angiography of massive hemorrhage secondary to pancreatic disease. Radiology 124: 337–342, 1977PubMedGoogle Scholar
  31. 31.
    Meyers MA, Ghahremani GG, Clements JL Jr, et al: Pneumatosis intestinalis. Gastrointest Radiol 2: 91–105, 1977PubMedCrossRefGoogle Scholar
  32. 32.
    Collins JJ Jr, Peterson LM, Wilson RE: Small intestinal infarction as a complication of pancreatitis. Ann Surg 167: 433–436, 1968PubMedCrossRefPubMedCentralGoogle Scholar
  33. 33.
    Dallemand S, Farman J, Stein D, et al: Colonic necrosis complicating pancreatitis. Gastrointest Radiol 2: 27–30, 1977PubMedCrossRefGoogle Scholar
  34. 34.
    Griffiths RW, Brown PW Jr: Jejunal infarction as a complication of pancreatitis. Gastroenterology 58: 709–712, 1970PubMedGoogle Scholar
  35. 35.
    Katz P, Dorman MJ, Aufses AH Jr: Colonic necrosis complicating postoperative pancreatitis. Ann Surg 179: 403–405, 1974PubMedCrossRefPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1988

Authors and Affiliations

  • Morton A. Meyers
    • 1
  1. 1.Department of Radiology, School of MedicineState University of New York at Stony BrookStony BrookUSA

Personalised recommendations