Acute pancreatitis - ischaemia or hyperaemia?

There is no accepted specific treatment for acute pancreatitis in man in spite of extensive investigations. Evidence is presented based on histology, vascular and blood flow studies to support the hypothesis that acute pancreatitis is unlike most inflammatory conditions since a rapid and severe ischaemia develops in the pancreas. In dogs for example there is an instant and maintained reduction in pancreatic blood flow reducing by 72% at 3 hours. Various treatments have been advocated in acute pancreatitis. Based upon the effect of dextran 40 in improving pancreatic blood flow and percentage cardiac output, it would appear to be a treatment of choice in acute pancreatitis.