PANCREATITIS PATHWAY

Chronic Alcoholic Pancreatitis

(Physiopathogenesis)

Ethanol – Induced loss or impairment of the “Pancreon’s brake”

(Pavlov vagal inhibitory fibres)
Failure of PP secretion and other neurotransmitters

Gut – Pancreatic Reflected “Pancreon” ecbolic

from the “antral” and “duodenal” response to CCK
autonomic brains

Intrapancreatic “Pancreon” Supranormal

Cholinergic tone ecbolic stimulation

Abrupt exacerbation Evolving Slowly

and Progressively

“Necrosis” Process

Apoptotic Process
Predominates

Acute Pancreatitis
Superimposed on
Chronic Pancreatitis
 PATHWAY

Biliary Acute Pancreatitis

“Autonomic – Arc – Reflexes”

Pancreatic Cytokines

Stimulation of the “Hypothalamic – Pituitary – Adrenal” (HPA) Axis

Glucorticoids Release completes the “Feedback Loop” and

Influences upon Pro – Inflammatory and
Anti – Inflammatory Cytokines Modulating Pancreatic Inflammation
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