Acute pancreatitis is an insidious inflammatory disease of the pancreas with its serious form leading to mortality in 20 to 30 % of patients. Seemingly good clinical state at the onset of the disease is the cause of underestimation of resuscitation care in first hours of the disease. Whereas a basic prevention of the development of multiorgan dysfunction are an early re-establishing of the microcirculation and supranormal hemodynamic values. Making a differential diagnosis of the mild and the severe form of pancreatitis is possible after several days of intensive resuscitation care. Treatment of complications of acute pancreatitis, especially a long-term inflammatory process in retroperitoneum, require a patient and sometimes several month lasting intensive approach and interdisciplinary co-operation. Too early removal of drainage from the area of a necrotic gland or suppuration in retroperitoneum can be fatal to the patient.

        Key words: Acute pancreatitis - SIRS - MOD - Septic shock - Hemodynamics - Microcirculation