Abstract
The gastrointestinal tract has been implicated as one of the main organ systems involved in the initiation of the acute inflammatory response that often follows shock. The exocrine functions of the pancreas include the secretion of digestive enzymes into the duodenal lumen. These intraluminal pancreatic enzymes may play a pivotal role in the pathogenesis of multiorgan failure after shock. This article reviews the literature surrounding the hypothesis that digestive enzymes produced by the pancreas are involved in the initiation of the systemic inflammatory response after shock and, ultimately, contribute to multiorgan failure and death.