Elastic tissue injury in human acute pancreatitis

Pancreatic vessel wall alterations were studied in tissue material obtained from six patients subjected to resection of the gland for acute necrotizing pancreatitis. Special attention was paid to elastic tissue damage, which was studied using special stains in light and electron microscopy. Vascular wall elastic laminae showed changes varying from fragmentation to complete dissolution. The outer elastic lamina was more consistently affected. Elastic tissue damage was observed in pancreatic areas with minor acinar alterations and in vessels with otherwise relatively well-preserved walls. These observations suggest 1/ an early participation of elastase in the production of tissue damage in human acute pancreatitis and 2/ a primary role for elastic tissue injury in the vascular alterations leading to haemorrhage and tissue necrosis through ischaemia.