ABSTRACT
Pancreatitis can tax all the resources of the surgical intensive care unit. Though some
triggers of the disease are understood, the mechanism of progression remains uncertain.
Most occurrences are mild and self-limited, but occasionally they progress to a more
severe, fulminant form that causes tremendous metabolic and physiologic stress. The
purpose of Ranson’s classic criteria is identification of the patient at risk for the most
severe disease and stratification of therapy to control disease progression and support
the systemic effects of the resultant inflammation (1). Every physician, regardless of spe-
cialty, has frantically scrambled at some point in training to remember these criteria in
preparation for a discussion of acute pancreatitis. What they identify are signs reflecting
the severity of the inflammatory response to tissue injury. Similar responses are found
in other inflammatory states, such as sepsis, severe trauma, and massive hemorrhage.
