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Pancreatitis as a complication of anticholinesterase insecticide intoxication.

Authors
Dressel-TD; Goodale-RL Jr.; Arneson-MA; Borner-JW
Source
Ann Surg 1979 Feb; 189(2):199-204
Link
NIOSHTIC No.
00190469
Abstract
In view of the occurrence of pancreatitis in a previously healthy 19 year old woman following the accidental ingestion of an anticholinesterase insecticide, experiments were conducted to determine if there were a causal relation between anticholinesterase intoxication and pancreatitis. In six mongrel dogs the pancreatic duct was perfused and intraductal pressures recorded. Intravenous (iv) dosing with 25mg/kg O,O-diethyl-O-(2-isopropyl-6-methyl-4- pyrimidinyl)phosphorothioate (333415) caused a significant increase in the mean pressure from 12 to 27 centimeters saline. Atropine was injected 45 minutes later at 75 micrograms/kilogram intravenously (iv) and caused the mean pressure to return to control levels. In a second group of dogs, the major pancreatic duct was cannulated through a duodenotomy and pancreatic juice collected by gravity into a small reservoir connected to a pressure transducer. Secretin was infused at a low dose level iv for 1 hour. As this infusion continued, a total of 75mg/kg of the anticholinesterase agent was given iv in three doses, 5 minutes apart. Secretin was discontinued 45 minutes later and atropine was administered 45 minutes later. Addition of the anticholinesterase agent caused a significant increase in the mean flow rate from 0.13 to 0.56 cubic centimeters/minute (cc/min). Atropine inhibited this stimulation. Exposure to the insecticide without Secretin stimulation resulted in flow rates not significantly different from the Secretin stimulated rate of 0.14cc/min. Two dogs in group 1 died. The other eight dogs receiving iv bolus doses of anticholinesterase in addition to Secretin developed acute hyperamylasemia and hyperlipasemia. The authors indicate this is the first report of this organophosphate anticholinesterase causing a functional ductal obstruction at the same time as stimulation of pancreatic exocrine secretion and is the first report of clinical pancreatitis complicating anticholinesterase insecticide intoxication.
Keywords
NIOSH-Publication; NIOSH-Grant; Grants-other; Pesticides; Organo-phosphorus-compounds; Organo-phosphorus-pesticides; Toxic-effects; Humans; Laboratory-animals; Digestive-system
Contact
Environmental Health University of Minnesota 1158 Mayo Memorial Minneapolis, Minn 55455
CODEN
ANSUA5
CAS No.
333-41-5
Publication Date
19790201
Document Type
Journal Article
Funding Amount
7317174
Funding Type
Grant
Fiscal Year
1979
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-T15-OH-007098; Grant-Number-T42-OH-007098
Issue of Publication
2
ISSN
0003-4932
Priority Area
Training
Source Name
Annals of Surgery
State
MN
Performing Organization
University of Minnesota of Mnpls-St Paul, Minneapolis, Minnesota
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