Acute Pancreatitis and Hepatic Necrosis in the Acute Afferent Loop Syndrome

Abstract

The morphological changes in the liver and pancreas during the first 12 hours in the acute afferent loop syndrome were studied in rats with a Billroth II gastric resection. Two essentially different types of changes were found in the pancreas. One was a coagulative necrosis without an inflammatory reaction, which has been found after instillation of bile, bile salts and the detergent sodium lauryl sulphate into the pancreatic ducts. The other type of pancreatitis was an intense, acute purulent inflammation often with bacteria visible in the histological sections. In the liver, large areas of necrosis were often encountered, sometimes mixed with polymorphonuclear leukocytes and bacteria, in a few cases combined with thrombi in small portal veins. The changes in the pancreas occurred very rapidly; only 4 hours after occlusion of the afferent loop there were signs of pancreatitis in some cases and 12 hours after occlusion there was an acute pancreatitis in all cases.