[Acute pancreatitis. Aspects of the pathophysiology (author's transl)]

Three aspects of the pathophysiology of acute pancreatitis are discussed: 1. the initiating mechanisms, 2. the mechanisms of the fat necrosis, 3. the processes leading to shock phenomena. It is pointed out that the intraglandular activation of the precursors for both lipolytic and proteolytic enzymes seems to be essential for the initiating mechanisms of the disease. The role of the hormone dependent lipolytic enzyme of the fat tissue is discussed in relation to the occurrence of extrapancreatic fat necrosis. The role of the vaso-active compounds, such as plasma kinins and histamine for the occurrence of shock during acute hemorrhagic pancreatitis is pointed out.