Alcohol Intake

Direct toxic effects on Contraction of

acinar cells sphoncter of Oddi

Liberation and pooling Pancreatic duct

of pancreatic enzymes obstruction

Digestive enzymes not

released in the
intestines

INCREASED SERUM
AMYLASE AND SERUM Autodigestion
LIPASE
 Autodigestion

Tissue necrosis

Inflammation

Activation of resident cells Increased release and activation

at the site of injury of inflammatory cells

Release of cell mediators

Emigration of
(IL-1, IL-6, & TNF) INCREASED WBC leukocytes and
(NEUTROPHILS) monocytes to the
site of injury
Acute phase reactions

FEVER
 Emigration of leukocytes and
monocytes to the site of injury

Release of microbicidal products from

dying neutrophils to extracellular
space

Leukocyte induced tissue injury

Activation of proteolytic Release of chemicals that

enzymes affecting adjacent stimulate pain receptors
tissues and organs (Bradykinin & Substance P)

Liver involvement
ABDOMINAL PAIN Gastric irritation

SLIGHT INCREASE
IN ALT
 Gastric irritation

Upper GI tract sends signals via vagal

and sympathetic nerve stimulation

Vomiting center in the brain stem

Subconscious excitation in the

Motor signals
area of medulla associated
with vomiting center

Diaphragm
Upper Lower and NAUSEA
GI tract GI tract abdominal
muscles

VOMITING
 Alcohol intake

Increased serum amylase and lipase

Increased WBC count (Neutrophil)

Fever

Slight increase in ALT

Abdominal pain

Nausea

Vomiting
 ACUTE
PANCREATITIS