From a mild self-limiting disease, development of multiple organ failure and frequently septic complications towards a fulminant course resistant to any type of treatment, acute pancreatitis is a disorder that has numerous causes, an obscure pathogenesis and an often unpredictable outcome. Following anecdotal reports'-3, acute pancreatitis first became widely recognized as a clinical and pathologic condition through an exhaustive review and systematic analysis of the course of the disease of 53 patients, reported more than a century ago by Reginald Fitz, Professor of Pathological Anatomy at the Harvard University'. In contrast to Senn', a Chicago surgeon, he initially considered early operative intervention ineffective and hazardous in these patients. Here the debate between medical and surgical therapy for acute pancreatitis originates and has continued ever since.

H.A. Bruining (Hajo)
Erasmus University Rotterdam
Erasmus MC: University Medical Center Rotterdam

Luiten, E. (1998, December 4). Severe acute pancreatitis and selective decontamination (Results of a Illulticentel' contl'olled clinical trial). Retrieved from