Epidemiology and Pathophysiology of Acute Pancreatitis

Abstract

Acute pancreatitis (AP) is an acute inflammatory process of the pancreas with variable involvement of the pancreas, regional tissues around the pancreas, or remote organ systems. The clinical course may range from mild discomfort with minimal pancreatic inflammation to severe necrotizing pancreatitis, complicated by multiorgan system failure and death. The most common etiologies are gallstones and alcohol abuse. The natural history is dependent on the degree of inflammation and necrosis. Following an acute attack, there is usually complete recovery of function if the offending agent is identified and removed. The pathogenesis of AP involves discrete intracellular events that prematurely activate intra-acinar zymogen granules and generate the release of proinflammatory and proapoptotic mediators. Understanding the natural history and specific roles of these cytokines may help develop therapies that can alter the course of severe pancreatitis and decrease its complications.