Skip to main content
SpringerLink
Log in

Mechanism of acute pancreatitis complicated with injury of intestinal mucosa barrier

  • Review
  • Published:
Journal of Zhejiang University SCIENCE B Aims and scope Submit manuscript

Abstract

Acute pancreatitis (AP) is a common acute abdomen in clinic with a rapid onset and dangerous pathogentic condition. AP can cause an injury of intestinal mucosa barrier, leading to translocation of bacteria or endotoxin through multiple routes, bacterial translocation (BT), gutorigin endotoxaemia, and secondary infection of pancreatic tissue, and then cause systemic inflammatory response syndrome (SIRS) or multiple organ dysfunction syndrome (MODS), which are important factors influencing AP’s severity and mortality. Meanwhile, the injury of intestinal mucosa barrier plays a key role in AP’s process. Therefore, it is clinically important to study the relationship between the injury of intestinal mucosa barrier and AP. In addition, many factors such as microcirculation disturbance, ischemical reperfusion injury, excessive release of inflammatory mediators and apoptosis may also play important roles in the damage of intestinal mucosa barrier. In this review, we summarize studies on mechanisms of AP.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Al-Omran, M., Groof, A., Wilke, D., 2003. Enteral versus parenteral nutrition for acute pancreatitis. Cochrane Database Syst. Rev., 1:CD002837.

    Google Scholar 

  • Ammori, B.J., Fitzgerald, P., Hawkey, P., McMahon, M.J., 2003. The early increase in intestinal permeability and systemic endotoxin exposure in patients with severe acute pancreatitis is not associated with systemic bacterial translocation: molecular investigation of microbial DNA in the blood. Pancreas, 26(1):18–22. [doi:10.1097/00006676-200301000-00004]

    Article  PubMed  CAS  Google Scholar 

  • Antonelli, A., Bianchi, M., Crinelli, R., Gentilini, L., Magnani, M., 2001. Modulation of ICAM-1 expression in ECV304 cells by macrophage-released cytokines. Blood Cells Mol. Dis., 27(6):978–991. [doi:10.1006/bcmd.2001.0470]

    Article  PubMed  CAS  Google Scholar 

  • Avgerinos, C., Delis, S., Rizos, S., Dervenis, C., 2003. Nutritional support in acute pancreatitis. Dig. Dis., 21(3): 214–219. [doi:10.1159/000073338]

    Article  PubMed  Google Scholar 

  • Bzowska, M., Guzik, K., Barczyk, K., Ernst, M., Flad, H.D., Pryjma, J., 2002. Increased IL-10 production during spontaneous apoptosis of monocytes. Eur. J. Immunol., 32(7):2011–2020. [doi:10.1002/1521-4141(200207)32:7〈2011::AID-IMMU2011〉3.0.CO;2-L]

    Article  PubMed  CAS  Google Scholar 

  • Carnovale, A., Rabitti, P.G., Manes, G., Esposito, P., Pacelli, L., Uomo, G., 2005. Mortality in acute pancreatitis: is it an early or a late event? JOP, 6(5):438–444.

    PubMed  Google Scholar 

  • Cheng, W.X., Jin, L.J., 1998. Study on apoptosis in multiple organs at early stage of rat intestinal ischemia-reperfusion injury. Chin. J. Traumatol., 14(6):381–383 (in Chinese).

    Google Scholar 

  • Closa, D., Folch-Puy, E., 2004. Oxygen free radicals and the systemic inflammatory response. IUBMB Life, 56(4): 185–191.

    Article  PubMed  CAS  Google Scholar 

  • de las Heras, G., Forcelledo, J.L., Gutierrez, J.M., Calvo, J., Obaya, S., Fernandez, F., Mayorga, M., Aguero, J., Pons, R.F., 2000. Selective intestinal bacterial decontamination in experimental acute pancreatitis. Gastroenterol. Hepatol., 23(10):461–465.

    PubMed  Google Scholar 

  • Dunger, A., Augstein, P., Schmidt, S., Fischer, U., 1996. Identification of interleukin 1-induced apoptosis in rat islets using in situ specific labelling of fragmented DNA. J. Autoimmun., 9(3):309–313. [doi:10.1006/jaut.1996.0042]

    Article  PubMed  CAS  Google Scholar 

  • Exner, R., Weingartmann, G., Eliasen, M.M., Gerner, C., Spittler, A., Roth, E., Oehler, R., 2002. Glutamine deficiency renders human monocytic cells more susceptible to specific apoptosis triggers. Surgery, 131(1):75–80. [doi:10.1067/msy.2002.118318]

    Article  PubMed  Google Scholar 

  • Foitzik, T., Kruschewski, M., Kroesen, A.J., Hotz, H.G., Eibl, G., Buhr, H.J., 1999. Does glutamine reduce bacterial translocation? A study in two animal models with impaired gut barrier. Int. J. Colorectal Dis., 14(3):143–149. [doi:10.1007/s003840050200]

    Article  PubMed  CAS  Google Scholar 

  • Foitzik, T., Eibl, G., Hotz, H.G., Faulhaber, J., Kirchengast, M., Buhr, H.J., 2000. Endothelin receptor blockade in severe acute pancreatitis leads to systemic enhancement of microcirculation, stabilization of capillary permeability, and improved survival rates. Surgery, 128(3):399–407. [doi:10.1067/msy.2000.107104]

    Article  PubMed  CAS  Google Scholar 

  • Foitzik, T., Eibl, G., Hotz, B., Hotz, H., Kahrau, S., Kasten, C., Schneider, P., Buhr, H.J., 2002. Persistent multiple organ microcirculatory disorders in severe acute pancreatitis: experimental findings and clinical implications. Dig. Dis. Sci., 47(1): 130–138. [doi:10.1023/A:1013284008219]

    Article  PubMed  CAS  Google Scholar 

  • Fukuyama, K., Iwakiri, R., Noda, T., Kojima, M., Utsumi, H., Tsunada, S., Sakata, H., Ootani, A., Fujimoto, K., 2001. Apoptosis induced by ischemia-reperfusion and fasting in gastric mucosa compared to small intestinal mucosa in rats. Dig. Dis. Sci., 46(3):545–549. [doi:10.1023/A:1005695031233]

    Article  PubMed  CAS  Google Scholar 

  • Furuya, T., Soeno, T., Komatsu, M., 2004. Strategy for bacterial translocation in acute pancreatitis. Nippon Shokakibyo Gakkai Zasshi, 101(5):502–509.

    PubMed  Google Scholar 

  • Garside, P., Millington, O., Smith, K.M., 2004. The anatomy of mucosal immune responses. Ann. N. Y. Acad. Sci., 1029(1):9–15. [doi:10.1196/annals.1309.002]

    Article  PubMed  CAS  Google Scholar 

  • Ginis, I., Jaiswal, R., Klimanis, D., Liu, J., Greenspon, J., Hallenbeck, J.M., 2002. TNF-alpha-induced tolerance to ischemic injury involves differential control of NF-kappaB transactivation: the role of NF-kappaB association with p300 adaptor. J. Cereb. Blood Flow Metab., 22(2):142–152. [doi:10.1097/00004647-200202000-00002]

    Article  PubMed  CAS  Google Scholar 

  • Gloor, B., Muller, C.A., Worni, M., Stahel, P.F., Redaelli, C., Uhl, W., Buchler, M.W., 2001. Pancreatic infection in severe pancreatitis: the role of fungus and multiresistant organisms. Arch. Surg., 136(5):592–596. [doi:10.1001/archsurg.136.5.592]

    Article  PubMed  CAS  Google Scholar 

  • Grady, E.F., Yoshimi, S.K., Maa, J., Valeroso, D., Vartanian, R.K., Rahim, S., Kim, E.H., Gerard, C., Gerard, N., Bunnett, N.W., et al., 2000. Substance P mediates inflammatory oedema in acute pancreatitis via activation of the neurokinin-1 receptor in rats and mice. Br. J. Pharmacol., 130(3):505–512. [doi:10.1038/sj.bjp.0703343]

    Article  PubMed  CAS  Google Scholar 

  • Harari, Y., Weisbrodt, N.W., Moody, F.G., 2000. Ileal mucosal response to bacterial toxin challenge. J. Trauma, 49(2):306–313.

    PubMed  CAS  Google Scholar 

  • Hotz, H.G., Foitzik, T., Rohweder, J., Schulzke, J.D., Fromm, M., Runkel, N.S., Buhr, H.J., 1998. Intestinal microcirculation and gut permeability in acute pancreatitis: early changes and therapeutic implications. J. Gastrointest. Surg., 2(6):518–525. [doi:10.1016/S1091-255X(98)80051-6]

    Article  PubMed  CAS  Google Scholar 

  • Ikeda, H., Suzuki, Y., Suzuki, M., Koike, M., Tamura, J., Tong, J., Nomura, M., Itoh, G., 1998. Apoptosis is a major mode of cell death caused by ischaemia and ischaemia/reperfusion injury to the rat intestinal epithelium. Gut, 42(4):530–537.

    Article  PubMed  CAS  Google Scholar 

  • Izumi, T., Saito, Y., Kishimoto, I., Harada, M., Kuwahara, K., Hamanaka, I., Takahashi, N., Kawakami, R., Li, Y., Takemura, G., et al., 2001. Blockade of the natriuretic peptide receptor guanylyl cyclase-A inhibits NF-kappaB activation and alleviates myocardial ischemia/reperfusion injury. J. Clin. Invest., 108(2):203–213. [doi:10.1172/JCI200112088]

    Article  PubMed  CAS  Google Scholar 

  • Jaworek, J., Jachimczak, B., Tomaszewska, R., Konturek, P.C., Pawlik, W.W., Sendur, R., Hahn, E.G., Stachura, J., Konturek, S.J., 2000. Protective action of lipopolysaccharidesin rat caerulein-induced pancreatitis: role of nitric oxide. Digestion, 62(1):1–13. [doi:10.1159/000007771]

    Article  PubMed  CAS  Google Scholar 

  • Ji, L., Yuan, Y.Z., Xu, J.Y., 2000. NF-κB and acute pancreatitis. Foreign Medicine Internal Medicine, 27(9): 396–398 (in Chinese).

    Google Scholar 

  • Jones, B.A., Gores, G.J., 1997. Physiology and pathophysiology of apoptosis in epithelial cells of the liver, pancreas, and intestine. Am. J. Physiol., 273(6):G1174–G1188.

    PubMed  CAS  Google Scholar 

  • Kazantsev, G.B., Hecht, D.W., Rao, R., Fedorak, I.J., Gattuso, P., Thompson, K., Djuricin, G., Prinz, R.A., 1994. Plasmid labeling confirms bacterial translocation in pancreatitis. Am. J. Surg., 167(1):201–206. [doi:10.1016/0002-9610(94)90074-4]

    Article  PubMed  CAS  Google Scholar 

  • Kiyono, H., Kweon, M.N., Hiroi, T., Takahashi, I., 2001. The mucosal immune system: from specialized immune defense to inflammation and allergy. Acta Odontol. Scand., 59(3):145–153. [doi:10.1080/000163501750266738]

    Article  PubMed  CAS  Google Scholar 

  • Lakshminarayanan, V., Lewallen, M., Frangogiannis, N.G., Evans, A.J., Wedin, K.E., Michael, L.H., Entman, M.L., 2001. Reactive oxygen intermediates induce monocyte chemotactic protein-1 in vascular endothelium after brief ischemia. Am. J. Pathol., 159(4):1301–1311.

    PubMed  CAS  Google Scholar 

  • Li, Z.L., 1998. Intestinal bacteria translocation and severe surgical cases. Chin. J. Surg., 36(A00):11–12 (in Chinese).

    Google Scholar 

  • Liu, J., Qiu, Z.J., Peng, Z.H., Zhong, F.Q., 2001. Secondary infection of acute severe pancreatitis in rats with enteral nutrition decrease. Parenter. Enteral Nutr., 8(4):224–226 (in Chinese).

    Google Scholar 

  • Liu, S.J., McHowat, J., 1998. Stimulation of different phospholipase A2 isoforms by TNF-alpha and IL-1beta in adult rat ventricular myocytes. Am. J. Physiol., 275(4): H1462–H1472.

    PubMed  CAS  Google Scholar 

  • Liu, Z.H., Striker, G.E., Stetler-Stevenson, M., Fukushima, P., Patel, A., Striker, L.J., 1996. TNF-alpha and IL-1 alpha induce mannose receptors and apoptosis in glomerular mesangial but not endothelial cells. Am. J. Physiol., 270(6):C1595–C601.

    PubMed  CAS  Google Scholar 

  • Maa, J., Grady, E.F., Yoshimi, S.K., Drasin, T.E., Kim, E.H., Hutter, M.M., Bunnett, N.W., Kirkwood, K.S., 2000. Substance P is a determinant of lethality in diet-induced hemorrhagic pancreatitis in mice. Surgery, 128(2):232–239. [doi:10.1067/msy.2000.107378]

    Article  PubMed  CAS  Google Scholar 

  • Marik, P.E., Zaloga, G.P., 2004. Meta-analysis of parenteral nutrition versus enteral nutrition in patients with acute pancreatitis. BMJ, 328(7453):1407. [doi:10.1136/bmj.38118.593900.55]

    Article  PubMed  Google Scholar 

  • Moine, P., McIntyre, R., Schwartz, M.D., Kancko, D., Shenkar, R., Le, T.Y., Moore, E.E., Abraham, E., 2000. NF-kappaB regulatory mechanisms in alveolar macrophages from patients with acute respiratory distress syndrome. Shock, 13(2):85–91.

    PubMed  CAS  Google Scholar 

  • Mole, D.J., Taylor, M.A., McFerran, N.V., Diamond, T., 2005. The isolated perfused liver response to a ’second hit’ of portal endotoxin during severe acute pancreatitis. Pancreatology, 5(4–5):475–485. [doi:10.1159/000086614]

    Article  PubMed  CAS  Google Scholar 

  • Neurath, M.F., Becker, C., Barbulescu, K., 1998. Role of NF-κB in immune and inflammatory responses in the gut. Gut, 43(6):856–860.

    PubMed  CAS  Google Scholar 

  • Nordback, I.H., Cameron, J.L., 1993. The mechanism of conversion of xanthine dehydrogenase to xanthine oxidase in acute pancreatitis in the canine isolated pancreas preperation. Surgery, 113(1):90–97.

    PubMed  CAS  Google Scholar 

  • Omoya, T., Shimizu, I., Zhou, Y., Okamura, Y., Inoue, H., Lu, G., Itonaga, M., Honda, H., Nomura, M., Ito, S., 2001. Effects of idoxifene and estradiol on NF-kappaB activation in cultured rat hepatocytes undergoing oxidative stress. Liver Int., 21(3):183–191. [doi:10.1034/j.1600-0676.2001.021003183.x]

    Article  CAS  Google Scholar 

  • Penalva, J.C., Martinez, J., Laveda, R., Esteban, A., Munoz, C., Saez, J., Such, J., Navarro, S., Feu, F., Sanchez-Paya, J., Perez-Mateo, M., 2004. A study of intestinal perme ability in relation to the inflammatory response and plasma endocab IgM levels in patients with acute pancreatitis. J. Clin. Gastroenterol., 38(6):512–517. [doi:10.1097/01.mcg.0000129060.46654.e0]

    Article  PubMed  CAS  Google Scholar 

  • Raab, S., Leiser, R., Kemmer, H., Claus, R., 1998. Effects of energy and purines in the diet on proliferation, differentiation, and apoptosis in the small intestine of the pig. Metabolism, 47(9):1105–1111. [doi:10.1016/S0026-0495(98)90285-2]

    Article  PubMed  CAS  Google Scholar 

  • Rahman, S.H., Ammori, B.J., Holmfield, J., Larvin, M., McMahon, M.J., 2003. Intestinal hypoperfusion contributes to gut barrier failure in severe acute pancreatitis. J. Gastrointest. Surg., 7(1):26–35. [doi:10.1016/S1091-255X(02)00090-2]

    Article  PubMed  Google Scholar 

  • Schmidt, J., Rattner, D.W., Lewandrowski, K., Compton, C.C., Mandavilli, V., Knoefel, W.T., Warshaw, A.L., 1992. A better model of acute pancreatitis for evaluating therapy. Ann. Surg., 215(1):44–56.

    Article  PubMed  CAS  Google Scholar 

  • Schwarz, M., Thomsen, J., Meyer, H., Buchler, M.W., Berger, H.G., 2000. Frequency and time course of pancreatic and extrapancreatic bacterial infection in experimental acute pancreatitis in rats. Surgery, 127(4):427–432. [doi:10.1067/msy.2000.104116]

    Article  PubMed  CAS  Google Scholar 

  • Shames, B.D., Barton, H.H., Reznikov, L.L., Cairns, C.B., Banerjee, A., Harken, A.H., Meng, X., 2002. Ischemia alone is sufficient to induce TNF-alpha mRNA and peptide in the myocardium. Shock, 17(2):114–119. [doi:10.1097/00024382-200202000-00006]

    Article  PubMed  Google Scholar 

  • Su, B., 1998. Study progress on apoptosis and ischemia-reperfusion injury. Foreign Medicine Surgery, 25(5):325–327 (in Chinese).

    Google Scholar 

  • Sunamura, M., Yamauchi, J., Shibuya, K., Chen, H.M., Ding, L., Takeda, K., Kobari, M., Matsuno, S., 1998. Pancreatic microcirculation in acute pancreatitis. J. Hepatobiliary Pancreat. Surg., 5(1):62–68. [doi:10.1007/PL00009952]

    Article  PubMed  CAS  Google Scholar 

  • Swank, G.M., Lu, Q., Xu, D.Z., Michalsky, M., Deitch, E.A., 1998. Effect of acute-phase and heat-shock stress on apoptosis in intestinal epithelial cells (Caco-2). Crit. Care Med., 26(7):1213–1217. [doi:10.1097/00003246-199807000-00023]

    Article  PubMed  CAS  Google Scholar 

  • Takahashi, Y., Fukushima, J., Fukusato, T., Shiga, J., Tanaka, F., Imamura, T., Fukayama, M., Inoue, T., Shimizu, S., Mori, S., 2005. Prevalence of ischemic enterocolitis in patients with acute pancreatitis. J. Gastroenterol., 40(8):827–832. [doi:10.1007/s00535-005-1637-5]

    Article  PubMed  Google Scholar 

  • Theuer, J., Dechend, R., Muller, D.N., Park, J.K., Fiebeler, A., Barta, P., Ganten, D., Haller, H., Dietz, R., Luft, F.C., 2002. Angiotensin II induced inflammation in the kidney and in the heart of double transgenic rats. BMC Cardiovasc. Disord., 2(1):3. [doi:10.1186/1471-2261-2-3]

    Article  PubMed  Google Scholar 

  • Valen, G., Yan, Z.Q., Hansson, G.K., 2001. Nuclear factor kappa-B and the heart. J. Am. Coll. Cardiol., 38(2):307–314. [doi:10.1016/S0735-1097(01)01377-8]

    Article  PubMed  CAS  Google Scholar 

  • Wang, X.P., Wang, B.X., Wu, K., Xu, X.F., 2001a. Role of apoptosis in death of intestinal mucosa epithelial cell at early stage of acute necrotic pancreatitis. Chin. J. Dig., 21(5):267–270 (in Chinese).

    CAS  Google Scholar 

  • Wang, X.P., Wu, K., Wang, B.X., Xu, X.F., Xu, M., Gong, Z.H., 2001b. Therapeutic effect of glutamine on intestinal failure of rats with acute necrotic pancreatitis. Chin. J. Intern. Med., 40(12):815–818 (in Chinese).

    CAS  Google Scholar 

  • Wang, X.P., Wang, B.X., Xu, X.F., Xie, C.G., Wu, K., XU, M., 2001c. CD44 mRNA expression of intestinal mucosa of rats with acute necrotic pancreatitis and role of somatropin. Chin. J. Exp. Surg., 18(4):305–306 (in Chinese).

    Google Scholar 

  • Wang, X.P., Wang, B.X., Wu, K., Xu, X.F., Xie, C.G., Xu, M., 2003. Excessive cytokine expression mediated by NF-κB of intestinal mucosa and role of somatropin in acute necrotic pancreatitis. Chin. J. Hepatobiliary Surg., 9(1):45–49 (in Chinese).

    Google Scholar 

  • Wang, Z., Castresana, M.R., Detmer, K., Newman, W.H., 2002. An IkappaB-alpha mutant inhibits cytokine gene expression and proliferation in human vascular smooth muscle cells. J. Surg. Res., 102(2):198–206. [doi:10.1006/jsre.2001.6320]

    Article  PubMed  CAS  Google Scholar 

  • Wang, Z.F., Pang, C.E., Liu, S.G., Liang, G.G., Zhang, M., 2000. Hemorheological change of acute necrotic pancreatitis and its significance. Chin. J. Gen. Surg., 9(3):225 (in Chinese).

    Google Scholar 

  • Wright, G., Singh, I.S., Hasday, J.D., Farrance, I.K., Hall, G., Cross, A.S., Rogers, T.B., 2002. Endotoxin stress-response in cardiomyocytes: NF-kappaB activation and tumor necrosis factor-alpha expression. Am. J. Physiol. Heart Circ. Physiol., 282(3):872–879.

    Google Scholar 

  • Wu, C.T., Li, Z.L., 1999. Role of nitrogen monoxidum and endothelin in intestinal injury of acute necrotic pancreatitis. Chin. J. Gen. Surg., 8(3):210–212 (in Chinese).

    Google Scholar 

  • Wu, Z.J., Zhang, Y.D., Lei, Z.M., Xu, S.H., 2003. Dynamic determination of concentration of TNF-α, IL-6 in peripheral blood of rats with acute necrotic pancreatitis and its significance. China J. Mod. Med., 13(4):23–25 (in Chinese).

    Google Scholar 

  • Yang, F.R., Lin, X.Z., 2002. Study progress on intestinal ischemical reperfusion injury. Chin. J. Integr. Tradit. Western Med., 8(4):319–321 (in Chinese).

    CAS  Google Scholar 

  • Yang, Y.J., Gao, N.R., 2005. Influence of endogenous nitrogen monoxidum on permeability of intestinal mucosa of rats with acute necrotic pancreatitis. World Chin. J. Digestol., 13(3):389–391 (in Chinese).

    CAS  Google Scholar 

  • Yin, J.B., Xiao, J.M., Wang, Y.Q., Wang, S.C., 2005. Acute pancreatitis and intestinal barrier injury, bacteria translocation and endotoxemia. Chin. J. Coal Ind. Med., 8(4):317–320 (in Chinese).

    Google Scholar 

  • Zhang, J.X., Qu, J.G., Cheng, G.Z., Li, L., Wang, X.Q., 2003. Changes of intestinal blood flow and phospholipase A2, interleukin-1β in serum of rats with acute necrotic pancreatitis. Basic Med. Sci. Clin., 23(5):556–558 (in Chinese).

    Google Scholar 

  • Zheng, T.B., Shi, X., Gao, N.R., Huo, M.D., Hu, H.L., Yang, Y.J., 2002. Expression of NK-1R and NK-2R in colon during acute necrotic pancreatitis. J. Pract. Med., 18(12):1272–1274 (in Chinese).

    Google Scholar 

  • Zou, S., Shao, H., Huang, D.R., Tian, F.Z., Yin, Z.L., Li, X.J., Wang, T., Gao, X.M., 2001. Experimental study on protecting mechanism of adenosine in intestinal barrier function during acute hemorrhagic necrotic pancreatitis. Chin. J. Gen. Surg., 10(4):305–308 (in Chinese).

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of General Surgery, Hangzhou First People’s Hospital, Hangzhou, 310006, China

    Zhang Xi-ping

  2. The First College of Clinical Medicine, Zhejiang University of Traditional Chinese Medicine, Hangzhou, 310053, China

    Zhang Jie, Song Qiao-ling & Chen Han-qin

Authors
  1. Zhang Xi-ping
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zhang Jie
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Song Qiao-ling
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Chen Han-qin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Zhang Xi-ping.

Additional information

Project supported by the Traditional Chinese Medicine Science of Zhejiang Province (Nos. 2003C130 and 2004C142), the Medical Science and Technology of Zhejiang Province (No. 2003B134), and the Technological Development of Hangzhou (No. 2003123B19), China

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zhang, Xp., Zhang, J., Song, Ql. et al. Mechanism of acute pancreatitis complicated with injury of intestinal mucosa barrier. J. Zhejiang Univ. - Sci. B 8, 888–895 (2007). https://doi.org/10.1631/jzus.2007.B0888

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1631/jzus.2007.B0888

Key words

CLC number

Search

Navigation