Background: Orderly cell death, termed apoptosis, features a morphology that is distinct from
necrotic, or accidental, cell death. As the body of literature on apoptotic cell death grows, it
is difficult for practicing surgeons to stay current with the involved mechanisms and their biologic
significance.
Methods: A MEDLINE/PubMed literature search was conducted, followed by manual crossreferencing, to identify relevant articles published in the English language between 1972 and 2004.
Results: Apoptosis is now known to be involved in numerous disease states. Ischemia-reperfusion injury and acute pancreatitis are but two surgical entities in which the balance of apoptotic
and necrotic cell death has a profound effect on clinical outcome. Similarly, the timing
and extent of apoptosis in immune cells are important factors that determine the outcome of
septic patients.
Conclusions: As already demonstrated in animal models, further research in this field will
target opportunities for therapeutic intervention, making it increasingly important for clinicians
to be familiar with apoptosis and necrosis, and their roles in normal and pathologic
states.
