The Pathogenesis of Pancreatitis

The second half of this century has been marked by the evolution of specialities in some branches of medicine, of which gastro-enterology has proved one of the more vigorous and successful. The development of intricate diagnostic and therapeutic techniques has fostered a tendency to overspecialization. In the past decade there has been a move to broaden the outlook. Workers who study the exocrine pancreas, both scientific and clinical, are now concerned not only with the endocrine pancreas but the liver and biliary tract as well because of the close embryological, anatomical and physiological relationships of the pancreas with these organs. In this volume, the concept of the secretory polarity of the acinar cell is reviewed and the concept of exit-block and the alternative non-regulated pathway via the basolateral membrane in pancreatitis is discussed. The possible validity of the role that oxygen-free radicals play in initiating attacks of acute pancreatitis and relapses of chronic pancreatitis is followed by reports of the Manchester preliminary trials of dietary modifications and the use of anti-oxidant supplements to reduce oxidative stress in these diseases.
The part played by leucocytes is reviewed in relation to haemorrhagic pancreatitis and cystic fibrosis of the pancreas.