INTESTINAL TRANSIT AND BACTERIAL TRANSLOCATION IN OBSTRUCTIVE PANCREATITIS

Pancreatic infection from gut-derived bacteria has emerged as the majo r cause of death in necrotizing pancreatitis. Bacterial overgrowth of indigenous enteric organisms as a consequence of gut stasis (ileus) re presents a potential initial event in this process. The present study was designed to examine the interrelationships between intestinal tran sit, enteric bacteriology, and the translocation of bacteria from the gut lumen to mesenteric lymph nodes and splanchnic viscera during expe rimentally induced acute pancreatitis. Male rats underwent pancreatico biliary duct ligation (PBDL) or sham surgery and were sacrificed after 24, 48, or 96 hr. Severity of pancreatitis was assessed with histolog y, tissue water content, and amylase and lipase levels, Intestinal tra nsit was measured with fluorescent tracers. Blood, mesenteric lymph no des (MLNs), splanchnic organs, and gut luminal contents were subjected to bacteriologic analysis. PBDL was followed by biochemical and histo logic evidence of progressive pancreatic injury at each time interval. Enteric bacteria within the gut and in adjacent MLNs increased as int estinal transit decreased after PBDL-induced pancreatic inflammation. Surprisingly, all parameters returned to control levels by 96 hr in sp ite of progression of pancreatic inflammation.