Overview
Clinical Meaning
Acute pancreatitis results from premature activation of trypsinogen to trypsin within the pancreatic acinar cells, triggering autodigestion of the gland.
CNPLE
CNPLE
Acute pancreatitis results from premature activation of trypsinogen to trypsin within the pancreatic acinar cells, triggering autodigestion of the gland. Gallstones (40%) obstruct the ampulla of Vater causing bile reflux, while alcohol (40%) directly injures acinar cells and increases ductal permeability. Activated trypsin initiates a proteolytic cascade activating elastase (vessel wall destruction), phospholipase A2 (fat necrosis), and kallikrein (vasodilation, edema), leading to local inflammation, third-spacing, and potential systemic inflammatory response syndrome (SIRS). Chronic pancreatitis involves progressive fibrotic replacement of exocrine and endocrine tissue, resulting in malabsorption (steatorrhea) and eventual endocrine insufficiency (diabetes mellitus type 3c).
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