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Acute pancreatitis: Etiology and common pathogenesis

Acute pancreatitis is an inflammatory disease of the pancreas. The etiology and pathogenesis of acute pancreatitis have been intensively investigated for centuries worldwide. Many causes of acute pancreatitis have been discovered, but the pathogenetic theories are controversial. The most common caus...

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Published in:World journal of gastroenterology : WJG 2009-03, Vol.15 (12), p.1427-1430
Main Authors: Wang, Guo-Jun, Gao, Chun-Fang, Wei, Dong, Wang, Cun, Ding, Si-Qin
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Language:English
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description Acute pancreatitis is an inflammatory disease of the pancreas. The etiology and pathogenesis of acute pancreatitis have been intensively investigated for centuries worldwide. Many causes of acute pancreatitis have been discovered, but the pathogenetic theories are controversial. The most common cause of acute pancreatitis is gallstone impacting the distal common bile-pancreatic duct. The majority of investigators accept that the main factors for acute billiary pancreatitis are pancreatic hyperstimulation and bile-pancreatic duct obstruction which increase pancreatic duct pressure and active trypsin reflux.Acute pancreatitis occurs when intracellular protective mechanisms to prevent trypsinogen activation or reduce trypsin activity are overwhelmed. However, little is known about the other acute pancreatitis. We hypothesize that acute biliary pancreatitis and other causes of acute pancreatitis possess a common pathogenesis. Pancreatic hyperstimulation and pancreatic duct obstruction increase pancreatic duct pressure, active trypsin reflux, and subsequent unregulated activation of trypsin within pancreatic acinar cells. Enzyme activation within the pancreas leads to auto-digestion of the gland and local inflammation. Once the hypothesis is confirmed, traditional therapeutic strategies against acute pancreatitis may be improved. Decompression of pancreatic duct pressure should be advocated in the treatment of acute pancreatitits which may greatly improve its outcome.
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Pancreatic hyperstimulation and pancreatic duct obstruction increase pancreatic duct pressure, active trypsin reflux, and subsequent unregulated activation of trypsin within pancreatic acinar cells. Enzyme activation within the pancreas leads to auto-digestion of the gland and local inflammation. Once the hypothesis is confirmed, traditional therapeutic strategies against acute pancreatitis may be improved. 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identifier ISSN: 1007-9327
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source PubMed Central(OpenAccess)
subjects Cholangiopancreatography, Endoscopic Retrograde - adverse effects
Cholestasis - complications
Gallstones - complications
Humans
Inflammation - physiopathology
Pancreatic Ducts - pathology
Pancreatitis - epidemiology
Pancreatitis - etiology
Pancreatitis - mortality
Pancreatitis - physiopathology
Pancreatitis, Acute Necrotizing - epidemiology
Pancreatitis, Acute Necrotizing - etiology
Pancreatitis, Acute Necrotizing - mortality
Pancreatitis, Acute Necrotizing - pathology
Review
发病机制
急性胆源性胰腺炎
急性胰腺炎
炎症性疾病
胰管阻塞
胰胆管梗阻
胰蛋白酶
title Acute pancreatitis: Etiology and common pathogenesis
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