Acute pancreatitis is the acute inflammation of the glandular pancreatic acinar cells, the consequence of parenchymal enzyme activation. Acinar local autodigestion which determines tissue destruction and ischemic necrosis sets in. Simultaneously, the local inflammatory reaction is followed by the release of pancreatic enzymes in the systemic circulation. In this situation, inflammatory cells appear, which stimulates the production of inflammatory mediators (1,2).
The loss of local control or exaggerated inflammatory reaction triggers the systemic inflammatory response syndrome (SIRS). The factors involved in determining the systemic response may be infectious (bacteria, viruses, fungi, parasites etc.), noninfectious (trauma, pancreatitis, burns etc.), or a combination of all the above (Fig. 1).