PANCREATIC STRUCTURAL AND FUNCTIONAL RESPONSES TO VARIOUS CHEMICAL BURNS OF THE GASTROINTESTINAL TRACT

Resume. Ingestion of corrosive agents leads to severe chemical injury of the upper gastrointestinal (GI) tract, with esophageal and gastric damage being well documented. In contrast, pancreatic involvement—although less common—remains insufficiently described despite its high morbidity. This review summarizes current evidence to clarify the morphological and functional alterations of the pancreas that occur after chemical burns of the digestive tract. A structured literature search identified pertinent clinical observations, case reports, and experimental studies. The analysis shows that pancreatic injury develops through two principal mechanisms: direct spread of necrosis from adjacent organs (such as the stomach and duodenum) and indirect systemic effects. Systemic damage results from an overwhelming inflammatory response, duodenal obstruction–related papillary edema, and a process known as “caustic oxidative stress,” which contributes to distant organ dysfunction. Morphological alterations vary from early edema and inflammation to extensive hemorrhagic necrosis described in surgical and autopsy findings. Histologically, acute stages are characterized by acinar cell necrosis, inflammatory infiltration, and vascular thrombosis, which may progress to fibrosis, sclerosis, and chronic pancreatitis over time. Functional impairments include disruptions of both exocrine and endocrine pancreatic activity. Clinically, acute pancreatitis manifests as intense abdominal pain accompanied by elevated amylase and lipase levels. Long-term consequences may involve exocrine insufficiency, malabsorption, and endocrine disorders such as diabetes mellitus. Experimental animal models have contributed significantly to understanding the mechanisms involved, including zymogen activation and oxidative pathways. Overall, this review underscores that pancreatic injury represents a serious, multifactorial complication of caustic ingestion, necessitating heightened clinical awareness for prompt diagnosis and treatment. Future investigations—particularly large prospective studies and assessments of emerging biomarkers like Pancreatic Stone Protein (PSP)—are essential to enhance patient outcomes. Keywords: Caustic ingestion; chemical burns; pancreatic injury; acute pancreatitis; pancreatic necrosis; morphological alterations; functional impairment; oxidative stress; gastrointestinal damage; corrosive substances.

Ҳали таржима қилинмаган