gastrointestinal disorders
Acute Pancreatitis
Pathogenesis of Acute Pancreatitis
Regardless of the etiology, an early event in pathogenesis of acute pancreatitis is intra-acinar activation of pancreatic enzymes (including trypsin, phospholipase A2, and elastase), leading to the autodigestive injury of the gland itself. The enzymes can damage tissue and activate the complement system and the inflammatory cascade, producing cytokines and causing inflammation and edema. This process causes necrosis in a few cases. Acute pancreatitis increases the risk of infection by compromising the gut barrier, leading to bacterial translocation from the gut lumen to the circulation. Activated enzymes and cytokines that enter the peritoneal cavity cause a chemical burn and third spacing of fluid; those that enter the systemic circulation cause a systemic inflammatory response that can result in Acute Hypoxemic Respiratory Failure (AHRF, ARDS) and 