[Vascular factors in the mechanism of acute pancreatitis]

Clinically, acute pancreatitis can sometimes be seen in local or systemic vascular diseases. Vascular mechanisms of acute pancreatitis are defined as impairment of pancreatic blood inflow and outflow, or disturbance of the pancreatic microcirculation. Pancreatic macro-circulatory flow can be impaired by low flow states such as hypovolemic shock, cardiogenic shock, or by occlusion of pancreatic arteries or veins. The pancreatic microcirculation can be compromised by embolization of microvessels or by induction of endothelial lesions. It is known that pancreatic ischemia is an initiating or promoting factor of acute pancreatitis. It has been proposed that impaired local pancreatic microcirculation results from leukocytes-endothelial cell adhesion and presence of various vasoactive substances or chemical mediators such as histamine, serotonin, prostaglandins, thromboxanes, leukotrienes, platelet-activating factor, endothelin, free radicals, kinins and adhesion glycoproteins.