The motility of the gastrointestinal tract decreases, with development of adynamic ileus and acute dilatation of the stomach and colon. Gastric hemorrhage and ulcerations are frequent; the incidence of Wischnevsky lesions found at autopsy approaches 80 per cent. These ulcerations develop more frequently in young healthy individuals and during slow-onset hypothermia. Cold-induced stress is attenuated in older debilitated patients; when the temperature falls rapidly, its effect is blunted.
Acute pancreatitis is common, but is sometimes limited to chemical expression only. Occasionally, a severe edematous or hemorrhagic and necrotic form may complicate and worsen outcome.
Hepatic function may be depressed, with impaired glucose utilization and lactate metabolism. Drug metabolism may be altered. Endocrine function
There is an initial increase in catecholamine and cortisol release. Pituitary hormone release decreases with the exception of thyroid-stimulating hormone. Serum epinephrine (adrenaline) and norepinephrine (noradrenaline) levels rise immediately after exposure to cold, but thyroxine levels increase later. Below 30 °C, hormone and catecholamine secretion is blunted. Insulin secretion is also blunted which, in association with a peripheral glucose utilization impairment, leads to hyperglycemia.
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