[Pathophysiology and treatment of severe pancreatitis]

The current study was designed to characterize toxic substances in hemorrhagic ascitic fluid by using in vivo dogs model and to examine the toxicity of hemorrhagic ascitic fluid by using an in vivo mice model injecting the fluid intraperitoneally. Our experiment showed that high levels of bradykinin, histamine and prostaglandin E were found in serum and in hemorrhagic ascitic fluid which reported as toxic substances during severe pancreatitis. A similar finding was also obtained clinically in four patients with severe acute pancreatitis. The mortality rate on 72 hours following the intraperitoneal injection of 2.0 and 3.0 ml of ascitic fluid were 66.0% and 89.7% respectively. Mice which died following the injection of ascitic fluid showed shock lung at autopsy. These results indicate that peritoneal lavage might be an effective method for the treatment of severe pancreatitis. We evaluated 25 patients with severe acute pancreatitis clinically. Laparotomy and drainage operations were performed in 16 patients of these patients. Twelve among 16 patient had good results. The cause of death were multiorgan failures.