INTRAVENOUS CONTRAST-MEDIUM AGGRAVATES THE IMPAIRMENT OF PANCREATIC MICROCIRCULATION IN NECROTIZING PANCREATITIS IN THE RAT

Background Previous reports demonstrated that radiographic contrast me dium, as used in contrast-enhanced computed tomography, increases acin ar necrosis and mortality in experimental pancreatitis. The authors st udied the possibility that these changes may be related to an addition al impairment of pancreatic microcirculation. Methods Fifty Wistar rat s had acute pancreatitis induced by intraductal glycodeoxycholic acid (10 mmol/L for 10 min) and intravenous cerulein (5 mu g/kg/hr for 6 hr s). After rehydration (16 mL/kg), pancreatic capillary perfusion was q uantified by means of intravital microscopy at baseline before intrave nous infusion of contrast medium (n = 25) or saline (n = 25), and 30 a nd 60 minutes thereafter. In addition to total capillary flow, capilla ries were categorized as high- or low-flow (> or < 1.6 nl/min). Result s Pancreatic capillary flow did not change in either high- or low-flow capillaries after saline infusion. However, contrast medium infusion induced a significant decrease of total capillary flow (p < 0.001). An alysis according to the relative flow rate revealed that this was prim arily because of a significant additional reduction of perfusion in lo w-flow capillaries (p < 0.0001). Furthermore, complete capillary stasi s was observed in 15.9 +/- 3.4% after contrast medium as compared with 3.2 +/- 1.2% after saline infusion (p < 0.006). Conclusion Radiograph ic contrast medium aggravates the impairment of pancreatic microcircul ation in experimental necrotizing pancreatitis.