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 Gallstones  Alcohol  Post-ERCP  Drugs  Hypertriglyceridemia.

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Presentation on theme: " Gallstones  Alcohol  Post-ERCP  Drugs  Hypertriglyceridemia."— Presentation transcript:

1  Gallstones  Alcohol  Post-ERCP  Drugs  Hypertriglyceridemia

2 intrapancreatic enzyme activation acinar cell injury intrapancreatic inflammatory reaction effects of activated proteolytic enzymes and cytokines on distant organs

3 Endotoxins, exotoxins, viral infections, ischemia, anoxia and direct trauma activate the zymogens. Activation is mediated by lysosomal hydrolases, such as Cathepsin B. Acinar cell injury

4 activation, chemoattraction, and sequestration of neutrophils intrapancreatic inflammatory reaction

5 Activated proteolytic enzymes digest pancreatic & peripancreatic tissues. Activation of other enzymesEnzymes digest cellular membranes. Proteolysis, edema, interstitial edema, vascular damage, coagulation & fat necrosis, and parenchymal cell necrosis

6 Bradykinin peptides, vasoactive substances and histamine vasodilation, increased vascular permeability and edema cellular injury and death

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