There have been relatively few reports describing pancreatic ischemia, because of the rarity of pancreatic ischemia and the inaccessibility of the pancreas itself. The rarity of pancreatic ischemia may be attributed to the richly arterial supply with numerous vascular anastomoses. Nonetheless, pancreatic ischemia exists as a separate entity, and should be differentiated from acute pancreatitis or fat necrosis. This article describes the distinctive morphologic features of pancreatic ischemia, representing the coagulative necrosis of pancreatic acinar cells, and discusses the subsequent features.

Copyright © 2007 S. Karger AG, Basel

Pancreatic ischemic necrosis or infarct is rare [1-3]. This rarity could be attributable to the rich arterial blood supply with numerous vascular anastomoses from the ramifications of two separate branches of the abdominal aorta [1, 2, 4]. Moreover, the inaccessibility of the pancreas may frequently interrupt the histological recognition of the ischemic changes because of the rapid onset of pancreatic autolysis in the postmortem period or after excision [4]. Furthermore, pancreatic ischemia may promptly induce other conditions, making its histological detection difficult. In fact, the two conditions, pancreatic infarct and acute hemorrhagic pancreatitis, may coincide, and the dividing line between them is clinically and histologically quite indefinite [2]. Some experimental studies also have concluded that vascular disturbances alone might actually initiate acute hemorrhagic pancreatitis [2]. Hence, there have been relatively few opportunities for pathologists to recognize the histopathological features of ischemic lesions. Nonetheless, McKay et al. noted that pancreatic infarct undoubtedly exists as a separate entity [3]. We also believe that detailed histological examination can detect ischemic lesions [5, 6]. This article describes and discusses the pathological characteristics of pancreatic ischemic lesions.

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