Towards a novel treatment strategy for acute pancreatitis. 1. Reappraisal of the evidence on aetiogenesis

Abstract

Despite more than a century of research endeavour, there is no specific medical treatment for acute pancreatitis and early mortality is high - 20% of fatalities by the day after admission. I do not see any realistic prospect that today's focus on immunomodulation will provide a breakthrough either. The signs are that the outcome of acute pancreatitis is determined almost at its inception, and that those unfortunate individuals in whom the seeds for a precipitous course are sewn do not declare themselves until it is too late. This reappraisal of the evidence on disease aetiogenesis has been undertaken in an effort to fathom why this might be.