Improvement of colonic capillary blood flow reduced bacterial translocation in acute pancreatitis

Background: In severe acute pancreatitis microcirculatory disorders are not confined to the pancreas, but can also be found in other organs, where the y are thought to contribute to the multi organ dysfunction syndrome. The ai m of the present study was to investigate whether therapy known to improve pancreatic microcirculation also enhances colonic perfusion and whether enh anced colonic capillary blood flow is associated with stabilization of inte stinal barrier function. ethods: Acute necrotizing pancreatitis was induced by retrograde intraducta l bile salt infusion followed by exocrine hyperstimulation with intravenous infusion of cerulein. We investigated the effect of hemo dilution therapy and endothelin-receptor-blockade on colonic microperfusion and bacterial tr anslocation. Results: Both measures significantly enhanced impaired colonic capillary bl ood flow. This was associated with reduced translocation of bacteria from t he gut into mesenteric lymph nodes and the pancreas. Conclusion: Our results further underline the hypothesis of the systemic mi cro circulatory disorders syndrome in severe acute pancreatitis and suggest that therapeutic measures aimed at improving microcirculation stabilize im paired organ function thereby counteracting the multi organ dysfunction syn drome in severe acute pancreatitis.