Skip to main content
SpringerLink
Log in

Pulmonary complications in fatal acute hemorrhagic pancreatitis

  • Original Articles
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Morphological changes of the lung occur frequently in fatal acute hemorrhagic pancreatitis. The pulmonary alterations are independent of mechanical ventilation and therefore not due to iatrogenic damage caused by high inspired oxygen concentrations. The histological findings are similar to those seen in the so-called shock lung syndrome. The pulmonary lesion develops progressively and three stages can be separated: early, late, and final phase. The pulmonary complications in acute hemorrhagic pancreatitis may be explained by the release of mediators such as pancreatic enzymes or free fatty acids into the blood stream. In acute hemorrhagic pancreatitis a close monitoring for shock parameters is necessary. A fall in arterial Po2 is an early indication for mechanical ventilation, including positive end-expiratory pressure.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Roseman DM, Kowlessar OD, Sleisenger MH: Pulmonary manifestations of pancreatitis. N Engl J Med 263:294–296, 1960

    Google Scholar 

  2. Fishbein R, Murphy GP, Wilder RJ: The pleuropulmonary manifestations of pancreatitis. Dis Chest 41:392–397, 1962

    Google Scholar 

  3. Kaye MD: Pleuropulmonary complications of pancreatitis. Thorax 23:297–306, 1968

    Google Scholar 

  4. Interiano B, Stuard ID, Hyde RW: Acute respiratory distress syndrome in pancreatitis. Ann Intern Med 77:923–926, 1972

    Google Scholar 

  5. Ranson JHC, Roses DF, Simon DF: Early respiratory insufficiency in acute pancreatitis. Ann Surg 178:75–79, 1973

    Google Scholar 

  6. Cameron AG: Acute respiratory failure in acute pancreatitis. Anaesth Intens Care 3:244–249, 1975

    Google Scholar 

  7. Imrie CW, Ferguson JC, Murphy D, Blumgart LH: Arterial hypoxia in acute pancreatitis. Br J Surg 64:185–188, 1977

    Google Scholar 

  8. Talvik R, Liigant A, Sissak HM, O'Konnel-Bronina N: Respiratory failure in acute pancreatitis. Intensive Care Med 3:97–98, 1977

    Google Scholar 

  9. Boumghar M, Cavin R: Respiratorische Komplikationen bei schwerer akuter Pankreatitis. Schweiz Rundschau Med (Praxis) 67:1394–1401, 1978

    Google Scholar 

  10. De Troyer A, Naeije R, Yernault J-C: Impairment of pulmonary function in acute pancreatitis. Chest 73:360–363, 1978

    Google Scholar 

  11. Warshaw AL, Lesser PB, Rie M, Cullen DJ: The pathogenesis of pulmonary edema in acute pancreatitis. Ann Surg 182:505–510, 1975

    Google Scholar 

  12. Ranson JHC, Turner JW, Roses DF, Rifkind KM, Spencer FC: Respiratory complications in acute pancreatitis. Ann Surg 179:557–565, 1974

    Google Scholar 

  13. Murphy D, Duncan JG, Imrie CW: The “negative chest radiograph” in acute pancreatitis. Br J Radiol 50:264–265, 1977

    Google Scholar 

  14. Rovner AJ, Westcott JL: Pulmonary edema and respiratory insufficiency in acute pancreatitis. Radiology 118:513–520, 1976

    Google Scholar 

  15. Mittermayer Ch, Ostendorf P, Riede UN: Pathologischanatomische Untersuchungen bei der respiratorischen Insuffizienz durch Schock. I. Lichtmikroskopische und biochemische Analyse. Intensivmed 14:252–262, 1977

    Google Scholar 

  16. Remmele W, Harms D: Zur pathologischen Anatomie des Kreislaufschocks beim Menschen. Klin Wochenschr 46:352–357, 1968

    Google Scholar 

  17. Bleyl U, Heilmann K, Adler D: Generalisierte plasmatische Hypercoagulabilität und pulmonale hyaline Membranen beim Erwachsenen. Klin Wochenschr 49:71–81, 1971

    Google Scholar 

  18. Mittermayer Ch, Riede UN: Frühphase der Schocklunge. Verh Dtsch Ges Pathol 62:34–39, 1978

    Google Scholar 

  19. Riede UN, Mittermayer Ch: Spätphase der Schocklunge. Verh Dtsch Ges Pathol 62:54–65, 1978

    Google Scholar 

  20. Burke JF, Pontoppidan H, Welch CE: High output respiratory failure: An important cause of death ascribed to peritonitis or ileus. Ann Surg 158:581–592, 1963

    Google Scholar 

  21. Amundsen E, Ofstad E, Hagen P-O: Histamine release induced by synergistic action of kallikrein and phospholipase A. Arch Int Pharmacodyn 178:104–114, 1969

    Google Scholar 

  22. Hagen P-O, Ofstad E, Amundsen E: Experimental acute pancreatitis in dogs. IV. The relationship between phospholipase A and the histamine-releasing and hypotensive effects of pancreatic exudate. Scand J Gastroenterol 4:89–96, 1969

    Google Scholar 

  23. Maciver AG, Metcalfe IL, Possmayer F, Harding PGR, Passi RB: Alteration of surfactant chemistry in experimental hemorrhagic pancreatitis. J Surg Res 23:311–314, 1977

    Google Scholar 

  24. Ashbaugh DG, Uzawa T: Respiratory and hemodynamic changes after injection of free fatty acids. J Surg Res 8:417–423, 1968

    Google Scholar 

  25. Kimura T, Toung JK, Margolis S, Permutt S, Cameron JL: Respiratory failure in acute pancreatitis. A possible role for trglycerides. Ann Surg 189:509–514, 1979

    Google Scholar 

  26. Hohn DC, Meyers AJ, Gherini ST, Beckmann A, Markison RE, Churg AM: Production of acute pulmonary injury by leukocytes and activated complement. Surgery 88:48–58, 1980

    Google Scholar 

  27. Lankisch PG, Koop H, Kaboth U: Serum complement factors in human acute pancreatitis. Hepato-Gastroenterol 28:261–263, 1981

    Google Scholar 

  28. Morgan AP, Jenny ME, Haessler H: Phospholipids, acute pancreatitis, and the lungs: Effect of lecithinase infusion on pulmonary surface activity in dogs. Ann Surg 167:329–335, 1968

    Google Scholar 

  29. Reinitz ER, Motoyama E, Smith GJW, Kerstein MD: Pulmonary sequellae of experimental pancreatitis. J Surg Res 22:566–579, 1977

    Google Scholar 

  30. Bolooki H, Mobin-Uddin K, Lombardo CR, Jude JR, Smith ME: Biophysical characteristics of lungs in acute pancreatitis. Surg Forum 19:371–373, 1968

    Google Scholar 

  31. Bolooki H, Minkowitz S, Giammona ST, Jude JR: Respiratory failure in acute pancreatitis. The biophysical characteristics of lungs in experimental pancreatitis. J Surg Oncol 3:31–42, 1971

    Google Scholar 

  32. Kellum JM, Demeester TR, Elkins RC, Zuidema GD: Respiratory insufficiency secondary to acute pancreatitis. Ann Surg 175:657–662, 1972

    Google Scholar 

  33. Hayes MF Jr, Rosenbaum RW, Zibelman M, Matsumoto T: Adult respiratory distress syndrome in association with acute pancreatitis. Evaluation of positive end expiratory pressure ventilation and pharmacologic doses of steroids. Am J Surg 127:314–319, 1974

    Google Scholar 

  34. Brzek V, Bartos V: Therapeutic effect of the prolonged thoracic duct lymph fistula in patients with acute pancreatitis. Digestion 2:43–50, 1969

    Google Scholar 

  35. Lankisch PG, Koop H, Winckler K, Schmidt H: Continuous peritoneal dialysis as treatment of acute experimental pancreatitis in the rat. I. Effect on length and rate of survival. Dig Dis Sci 24:111–116, 1979

    Google Scholar 

  36. Lankisch PG, Koop H, Winckler K, Schmidt H: Continuous peritoneal dialysis as treatment of acute experimental pancreatitis in the rat. II. Analysis of its beneficial effect. Dig Dis Sci 24:117–121, 1979

    Google Scholar 

  37. Ranson JHC, Spencer FC: The role of peritoneal lavage in severe acute pancreatitis. Ann Surg 187:565–573, 1978

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Gastroenterology and Metabolism, Department of Medicine, University of Göttingen, Göttingen, Germany

    P. G. Lankisch PD, G. Rahlf Prof. & H. Koop MD

  2. Institute of Pathology, University of Göttingen, Göttingen, Germany

    P. G. Lankisch PD, G. Rahlf Prof. & H. Koop MD

Authors
  1. P. G. Lankisch PD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. G. Rahlf Prof.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. H. Koop MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lankisch, P.G., Rahlf, G. & Koop, H. Pulmonary complications in fatal acute hemorrhagic pancreatitis. Digest Dis Sci 28, 111–116 (1983). https://doi.org/10.1007/BF01315139

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01315139

Keywords

Search

Navigation