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. 1994 Sep;35(9):1306–1310. doi: 10.1136/gut.35.9.1306

Routes of spread of pathogens into the pancreas in a feline model of acute pancreatitis.

A L Widdison 1, N D Karanjia 1, H A Reber 1
PMCID: PMC1375713  PMID: 7959243

Abstract

The routes of spread of pathogens into the pancreas in acute pancreatitis were investigated. Four experiments were performed: (1) cats with and without acute pancreatitis were given 10(7) Escherichia coli (E coli) intravenously, (2) in cats with acute pancreatitis 10(8) E coli was placed in the colon. In half of them the colon was then enclosed in an impermeable bag to prevent transmural spread. (3) E coli (10(4)) was placed in the pancreatic duct in cats with and without acute pancreatitis. (4) In cats with acute pancreatitis 10(5) E coli was placed in the gall bladder. In half of them the common bile duct was ligated to prevent biliary-pancreatic reflux. After 24 hours, intravenous E coli infected the pancreas in six of nine cats with acute pancreatitis and three of 10 controls. After 72 hours E coli spread to the pancreas from the colon in six of nine cats with acute pancreatitis. This was prevented by enclosing the colon in an impermeable bag (p = 0.02). In five of six cats with acute pancreatitis and five of six controls E coli placed in the pancreatic duct colonised the pancreas within 24 hours. Pancreatic colonisation from the gall bladder occurred in five of six cats with a patent common bile duct and in three of six with an obstructed common bile duct. In conclusion, in cats E coli can spread to the pancreas by the blood stream, transmurally from the colon, and by reflux into the pancreatic duct.

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Selected References

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  1. Armstrong C. P., Taylor T. V. Pancreatic-duct reflux and acute gallstone pancreatitis. Ann Surg. 1986 Jul;204(1):59–64. doi: 10.1097/00000658-198607000-00008. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. BENACERRAF B., SEBESTYEN M. M., SCHLOSSMAN S. A quantitative study of the kinetics of blood clearance of P32-labelled Escherichia coli and Staphylococci by the reticuloendothelial system. J Exp Med. 1959 Jul 1;110(1):27–48. doi: 10.1084/jem.110.1.27. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Beger H. G., Bittner R., Block S., Büchler M. Bacterial contamination of pancreatic necrosis. A prospective clinical study. Gastroenterology. 1986 Aug;91(2):433–438. doi: 10.1016/0016-5085(86)90579-2. [DOI] [PubMed] [Google Scholar]
  4. Büchler M., Malfertheiner P., Friess H., Isenmann R., Vanek E., Grimm H., Schlegel P., Friess T., Beger H. G. Human pancreatic tissue concentration of bactericidal antibiotics. Gastroenterology. 1992 Dec;103(6):1902–1908. doi: 10.1016/0016-5085(92)91450-i. [DOI] [PubMed] [Google Scholar]
  5. Carr-Locke D. L., Gregg J. A. Endoscopic manometry of pancreatic and biliary sphincter zones in man. Basal results in healthy volunteers. Dig Dis Sci. 1981 Jan;26(1):7–15. doi: 10.1007/BF01307970. [DOI] [PubMed] [Google Scholar]
  6. Everett E. D., Hirschmann J. V. Transient bacteremia and endocarditis prophylaxis. A review. Medicine (Baltimore) 1977 Jan;56(1):61–77. [PubMed] [Google Scholar]
  7. Farringer J. L., Jr, Robbins L. B., 2nd, Pickens D. R., Jr Abscesses of the pancreas. Surgery. 1966 Nov;60(5):964–970. [PubMed] [Google Scholar]
  8. Gregg J. A., Carr-Locke D. L. Endoscopic pancreatic and biliary manometry in pancreatic, biliary, and papillary disease, and after endoscopic sphincterotomy and surgical sphincteroplasty. Gut. 1984 Nov;25(11):1247–1254. doi: 10.1136/gut.25.11.1247. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Huang T., Bass J. A., Williams R. D. The significance of biliary pressure in cholangitis. Arch Surg. 1969 May;98(5):629–632. doi: 10.1001/archsurg.1969.01340110121014. [DOI] [PubMed] [Google Scholar]
  10. Kreger B. E., Craven D. E., Carling P. C., McCabe W. R. Gram-negative bacteremia. III. Reassessment of etiology, epidemiology and ecology in 612 patients. Am J Med. 1980 Mar;68(3):332–343. doi: 10.1016/0002-9343(80)90101-1. [DOI] [PubMed] [Google Scholar]
  11. Lygidakis N. J., Brummelkamp W. H. Bacteremia in relation to intrabiliary pressure in proximal v. distal malignant biliary obstruction. Acta Chir Scand. 1986 Apr;152:305–307. [PubMed] [Google Scholar]
  12. Neoptolemos J. P., Carr-Locke D. L., Leese T., James D. Acute cholangitis in association with acute pancreatitis: incidence, clinical features and outcome in relation to ERCP and endoscopic sphincterotomy. Br J Surg. 1987 Dec;74(12):1103–1106. doi: 10.1002/bjs.1800741210. [DOI] [PubMed] [Google Scholar]
  13. ROGERS D. E. Host mechanisms which act to remove bacteria from the blood stream. Bacteriol Rev. 1960 Mar;24(1):50–66. doi: 10.1128/br.24.1.50-66.1960. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. SCHWEINBURG F. B., SELIGMAN A. M., FINE J. Transmural migration of intestinal bacteria; a study based on the use of radioactive Escherichia coli. N Engl J Med. 1950 May 11;242(19):747–751. doi: 10.1056/NEJM195005112421903. [DOI] [PubMed] [Google Scholar]
  15. Scott-Conner C. E., Grogan J. B., Scher K. S., Bernstein J. Impaired clearance of Escherichia coli bacteremia in early biliary obstruction. Am J Surg. 1989 Feb;157(2):210–214. doi: 10.1016/0002-9610(89)90530-8. [DOI] [PubMed] [Google Scholar]
  16. Steffen E. K., Berg R. D., Deitch E. A. Comparison of translocation rates of various indigenous bacteria from the gastrointestinal tract to the mesenteric lymph node. J Infect Dis. 1988 May;157(5):1032–1038. doi: 10.1093/infdis/157.5.1032. [DOI] [PubMed] [Google Scholar]
  17. Tarpila E., Nyström P. O., Franzén L., Lilja I., Ihse I. Acute experimental suppurative pancreatitis in the rat. Acta Chir Scand. 1988 May-Jun;154(5-6):379–383. [PubMed] [Google Scholar]
  18. Taylor T. V., Rimmer S. Pancreatic-duct reflux in patients with gallstone pancreatitis? Lancet. 1980 Apr 19;1(8173):848–850. doi: 10.1016/s0140-6736(80)91354-9. [DOI] [PubMed] [Google Scholar]
  19. Warshaw A. L. Pancreatic abscesses. N Engl J Med. 1972 Dec 14;287(24):1234–1236. doi: 10.1056/NEJM197212142872406. [DOI] [PubMed] [Google Scholar]
  20. Wells C. L., Maddaus M. A., Simmons R. L. Proposed mechanisms for the translocation of intestinal bacteria. Rev Infect Dis. 1988 Sep-Oct;10(5):958–979. doi: 10.1093/clinids/10.5.958. [DOI] [PubMed] [Google Scholar]
  21. Wells C. L., Rotstein O. D., Pruett T. L., Simmons R. L. Intestinal bacteria translocate into experimental intra-abdominal abscesses. Arch Surg. 1986 Jan;121(1):102–107. doi: 10.1001/archsurg.1986.01400010116016. [DOI] [PubMed] [Google Scholar]
  22. Widdison A. L., Alvarez C., Reber H. A. Surgical intervention in acute pancreatitis: when and how. Pancreas. 1991;6 (Suppl 1):S44–S51. doi: 10.1097/00006676-199101001-00008. [DOI] [PubMed] [Google Scholar]
  23. Widdison A. L., Alvarez C., Reber H. A. The low-pressure duct perfusion model of acute pancreatitis. Eur Surg Res. 1992;24 (Suppl 1):55–61. doi: 10.1159/000129239. [DOI] [PubMed] [Google Scholar]
  24. Widdison A. L., Karanjia N. D., Alvarez C., Reber H. A. Influence of levamisole on pancreatic infection in acute pancreatitis. Am J Surg. 1992 Jan;163(1):100–104. doi: 10.1016/0002-9610(92)90260-x. [DOI] [PubMed] [Google Scholar]
  25. Widdison A. L., Karanjia N. D. Pancreatic infection complicating acute pancreatitis. Br J Surg. 1993 Feb;80(2):148–154. doi: 10.1002/bjs.1800800208. [DOI] [PubMed] [Google Scholar]
  26. Williamson R. C. Early assessment of severity in acute pancreatitis. Gut. 1984 Dec;25(12):1331–1339. doi: 10.1136/gut.25.12.1331. [DOI] [PMC free article] [PubMed] [Google Scholar]

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