Studieson the Pancreas in Liver Diseases:I. Histologic Changes of the Pancreas in Liver Cirrhosis
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概要
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An attempt was made to clarify the pathogenesis of pancreatic lesions in cirrhosis of the liver.The pancreas was studied histologically in 45 autopsy cases with liver cirrhosis and 30 control cases without hepatic, pancreatic and cardiac diseases. Interstitial leukocytic reaction of mild to moderate degree was found in the pancreas of 42% of cases with cirrhosis. Mild to moderate parenchyma) necrosis of the pancreas was observed in 47% of cirrhotics. There was mild to severe fibrosis of the pancreas in 78% of cirrhotics. These incidences of pancreatic lesions of cirrhotic group were significantly higher than those of the control group. Inflammatory or necrotic changes were almost exclusively concurrent with fibrosis. On the other hand, fibrosis was not always accompanied by the other two pancreatic lesions. Therefore fibrosis was considered as the most fundamental lesion of the pancreas in cirrhosis of the liver. Iron deposit was revealed in eight of 27 cirrhotic cases.In cirrhotics with moderate to severe fibrosis of the pancreas, bromsulphalein excretion was significantly delayed comparing to those with mild or no fibrosis. Splenomegaly (over 200g) was found in 20 of 37 cases with cirrhosis. Esophageal varices were seen in 26 of 30 cases with cirrhosis. Incidences of pancreatic lesions in cases with splenomegaly, were not higher than those in cases without splenomegaly. So it was suggested that portal hypertension was not the sole contributory factor on the development of pancreatic lesions in liver cirrhosis, although it would not be neglected as a participating factor of the lesions. Eleven of 30 cases with cirrhosis consumed more than 180ml of Japanese Sake per day in averages when those were alive. In these cases, pancreatic lesions were not severe comparing to cases in which consumption of the alcoholic beverage was below 180ml per day. Therefore it appears that alcohol was not the major factor of the pancreaticc lesions.It would be concluded that pancreatic lesions occur in cirrhosis of the liver in significantly high incidences. Any single factor such as portal hypertension, alcohol ingestion or iron deposits might not be the sole cause of pancreatic lesions. Here arises the possibility that multiple factors participate in pathogenesis of the pancreatic lesions in cirrhosis of the liver.
- 財団法人 日本消化器病学会の論文
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関連論文
- Studies on the Pancreas in Liver Diseases:II. Exocrine Function of the Pancreas in Liver Cirrhosis and Chronic Hepatitis
- Studieson the Pancreas in Liver Diseases:I. Histologic Changes of the Pancreas in Liver Cirrhosis