Pathophysiology of pulmonary complications of acute pancreatitis

Table 1 Complications of acute pancreatitis

I Pancreatic

1 Necrosis-sterile vs infected

2 Pseudocyst-infection/rupture/hemorrhage

3 Abscess

II Local-extrapancreatic

1 Involvement of contiguous organs (intraperitoneal hemorrhage, GI bleeding, thrombosis of splenic vein, bowel infarction)

2 Pancreatic ascites

3 Obstructive jaundice

III Systemic

1 Pulmonary

a Early arterial hypoxia

b Atelectasis, pneumonia, pleural effusion, mediastinal abscess

c ARDS

2 Cardiac: shock, pericardial effusion, EKG changes, arrhythmias

3 Hematologic: DIC, TTP/HUS

4 Gastrointestinal: GI bleeding (portal-splenic vein thrombosis, colonic infarction)

5 Renal: azotemia, oliguria

6 Metabolic: hypocalcemia, hyperglycemia, hypertriglyceridemia, acidosis, elevation of free fatty acids

7 CNS: psychosis, pancreatic encephalopathy, Purtscher’s retinopathy

8 Peripheral: fat necrosis (skin and bones), arthritis

9 Miscelaneous: rhabdomyolysis