Anis Chaari, Karim Abdel Hakim, Kamel Bousselmi, Mahmoud Etman, Mohamed El Bahr, Ahmed El Saka, Eman Hamza, Mohamed Ismail, Elsayed Mahmoud Khalil, Vipin Kauts, William Francis Casey MINIREVIEWS 526 July 15, 2016|Volume 8|Issue 7| WJGO|www.wjgnet.com Pancreatic injury in patients with septic shock: A literature review Anis Chaari, Karim Abdel Hakim, Kamel Bousselmi, Mahmoud Etman, Mohamed El Bahr, Ahmed El Saka, Eman Hamza, Mohamed Ismail, Elsayed Mahmoud Khalil, Vipin Kauts, William Francis Casey, Department of Intensive Care, King Hamed University Hospital, Al Muharaq 24343, Bahrain Author contributions: All authors equally contributed to this paper with conception and design of the study, literature review and analysis, drafting and critical revision and editing, and fnal approval of the fnal version. Conflict-of-interest statement: All the authors declare they have no confict of interest. Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/ licenses/by-nc/4.0/ Manuscript source: Invited manuscript Correspondence to: Anis Chaari, MD, Department of Intensive Care, King Hamed University Hospital, Bilding 234, Road 2835, Block 228, Bussaiteen, Al Muharaq 24343, Bahrain. anischaari2004@yahoo.fr Telephone: +973-38073955 Fax: +973-17766428 Received: March 16, 2016 Peer-review started: March 18, 2016 First decision: April 18, 2016 Revised: April 26, 2016 Accepted: May 17, 2016 Article in press: May 27, 2016 Published online: July 15, 2016 Abstract Sepsis and septic shock are life threatening condition associated with high mortality rate in critically-ill patients. This high mortality is mainly related to the inadequacy between oxygen delivery and cellular demand leading to the onset of multiorgan dysfunction. Whether this multiorgan failure affect the pancreas is not fully inves- tigated. In fact, pancreatic injury may occur because of ischemia, overwhelming infammatory response, oxidative stress, cellular apoptosis and/or metabolic derangement. Increased serum amylase and/or lipase levels are common in patients with septic shock. However, imaging test rarely reveal signifcant pancreatic damage. Whether pancreatic dysfunction does affect the prognosis of patients with septic shock or not is still a matter of debate. In fact, only few studies with limited sample size assessed the clinical relevance of the pancreatic injury in this group of patients. In this review, we aimed to describe the epidemiology and the physiopathology of pancreatic injury in septic shock patients, to clarify whether it requires speci fc management and to assess its prognostic value. Our main finding is that pancreatic injury does not significantly affect the outcome in septic shock patients. Hence, increased serum pancreatic enzymes without clinical features of acute pancreatitis do not require further imaging investigations and specifc therapeutic intervention. Key words: Septic shock; Pancreas; Lipase; Amylase; Prognosis © The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved. Core tip: Pancreatic injury is common in septic shock patients. Tissue hypoperfusion is the main leading cause of pancreatic insult. Other factors such as oxidative stress Submit a Manuscript: http://www.wjgnet.com/esps/ Help Desk: http://www.wjgnet.com/esps/helpdesk.aspx DOI: 10.4251/wjgo.v8.i7.526 World J Gastrointest Oncol 2016 July 15; 8(7): 526-531 ISSN 1948-5204 (online) © 2016 Baishideng Publishing Group Inc. All rights reserved.