A 67-year-old woman with a long history of cholecystitis suddenly developed sharp pain in the upper part of the abdomen, along with nausea and vomiting after food intake. Acute pancreatitis was diagnosed in this patient.

What is the main link in the pathogenesis of this disease?

A. Preliminary activation of pancreatic enzymes
B. Decrease in enzyme levels in pancreatic juice
C. Intensification of enzyme activation in the duodenum
D. Reduction of pancreatic polypeptide secretion
E. Increased level of cholecystokinin

The main link in the pathogenesis of acute pancreatitis in this patient is preliminary activation of pancreatic enzymes. Acute pancreatitis is commonly caused by the premature activation of digestive enzymes within the pancreas. In normal conditions, these enzymes are activated in the duodenum after being released in their inactive form from the pancreas. However, in cases of cholecystitis or gallbladder disease, the release of bile into the duodenum can be obstructed, leading to the accumulation and activation of pancreatic enzymes within the pancreas itself.

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