Experimental pancreatitis after surfactant exposure

Area of Science:

• Gastroenterology
• Radiology
• Toxicology

Background:

• Endoscopic retrograde pancreatography (ERP) utilizes contrast agents for visualizing the pancreatic duct.
• Polyoxyethylene hydrogenated castor oil is a surface-active agent used as a pancreatic ductogram enhancer.
• Potential adverse effects of contrast agents in pancreatic procedures require thorough investigation.

Purpose of the Study:

• To evaluate the effects of pancreatic intraductal infusions of polyoxyethylene hydrogenated castor oil in a canine model.
• To determine the potential toxicity and inflammatory response associated with this contrast agent.
• To identify factors contributing to the observed adverse effects.

Main Methods:

• Retrograde infusions of 5% polyoxyethylene hydrogenated castor oil into the main pancreatic duct of dogs.
• Comparison with saline solution control group.
• Investigation of inflammatory changes following infusions, including pH buffering and direct ductal perfusion.
• Analysis of inflammatory changes associated with specific fatty acids (oleic and ricinoleic).

Main Results:

• Infusions of polyoxyethylene hydrogenated castor oil induced significantly greater pancreatitis-like changes compared to saline controls.
• These inflammatory changes persisted even after pH buffering and pressure normalization.
• Similar inflammatory responses were observed with oleic and ricinoleic fatty acids at concentrations matching the agent's acidity.
• Free fatty acids and surface activity are postulated as potential contributors to toxicity.

Conclusions:

• Polyoxyethylene hydrogenated castor oil may induce pancreatitis-like changes in the pancreas.
• Residual free fatty acids and the agent's surface-active properties are implicated in its toxicity.
• Further research and caution are advised before widespread clinical use in endoscopic retrograde pancreatography.