Effects of chronic pancreatic impairment on development of acute pancreatitis

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Little is known about pancreatic exocrine function during acute exacerbation in patients with chronic pancreatitis. We investigated changes in pancreatic exocrine function after inducing acute pancreatitis in an animal model of spontaneous chronic pancreatitis. WBN/Kob rats with chronic pancreatitis sequentially underwent pancreatic exocrine function test one to six days after surgical preparation with external pancreatic fistula. We induced acute pancreatitis in another WBN/Kob rats by intravenous administration of caerulein at a rate of 10 μg/kg/hr for 4 hours four days after surgical preparation. Pancreatic exocrine function test was undertaken in a conscious state one day before and after caerulein administration. In WBN/Kob rats not given caerulein, pancreatic exocrine function remained almost constant at 3-6 days after surgery. Marked hyperamylasemia developed immediately after caerulein administration. After its administration, the pancreas microscopically showed prominent interstitial edema and intracellular vacuolization of acinar cells in addition to the finding of preexisting chronic pancreatitis. Basal and cholecystokinin-stimulated flow rate, bicarbonate output, and protein output, which were substantially impaired one day before caerulein administration, were further reduced one day after its administration. Pancreatic exocrine hypofunction is markedly deteriorated during acute exacerbation in a rat model with chronic pancreatitis.