Steroid administration and acute pancreatitis: studies with an isolated, perfused canine pancreas.

: Steroid administration has been suspected of causing acute pancreatitis for over 20 years. Clinical and experimental data, however, have failed to firmly establish the association or to uncover a pathogenic mechanism. Utilizing an isolated, ex vivo, perfused, canine pancreas preparation, the acute effects of large doses of steroids on the pancreas were evaluated. Using a dose of 200 mg of methylprednisolone, there were no significant differences between the control and steroid-treated preparations in terms of gross appearance, weight gain, serum amylase, or pancreatic secretion over a 4 hour perfusion period. When the dose of methylpredisolone was increased to 400 mg, again there were no significant differences in gross appearance, weight gain, or serum amylase during a 3 hour perfusion period. However, pancreatic secretion was initially depressed in the steroid-treated preparations. Following a maximal secretory stimulus (secretin), secretion markedly increased during the fourth hour of perfusion, but again was significantly less in the steroid-treated glands. Viscosity of pancreatic secretions was significantly increased in the steroid-treated glands. These studies suggest that steroids have a mild inhibitory effect on pancreatic secretion, which might be mediated through an increase in viscosity.