Acute pancreatitis is an inflammatory condition of the pancreas that can be life-threatening if it is not managed and treated in a timely manner. It is typically divided into two distinct phases: the initial inflammatory phase and the subsequent organ failure phase.
Initial inflammatory phase
The initial inflammatory phase is caused by the direct injury to the pancreatic tissue. This injury leads to an increase in the production of inflammatory mediators, such as cytokines and chemokines, which in turn cause local microvascular injury, increased vascular permeability, and edema. This phase is characterized by severe abdominal pain, nausea, vomiting, and elevated levels of amylase and lipase. Other symptoms may include fever, tachycardia, and hypotension.
Organ failure phase
The organ failure phase occurs when the inflammatory process triggers systemic inflammatory response syndrome (SIRS). This phase is characterized by widespread organ dysfunction, including respiratory, renal, cardiovascular, and neurologic dysfunction. It is also characterized by sepsis, hypotension, and elevated levels of lactate, creatinine, and bilirubin. Treatment at this stage is focused on preventing further organ dysfunction and mortality.