Splanchnic artery occlusion and reperfusion (SAO/R) results in a severe form of circulatory shock that has a high mortality rate. To examine the time course of the early events involved in SAO/R, occlusion of the superior mesenteric artery (SMA) and the celiac artery (120 min) were followed by reperfusion periods of 0, 2.5, 5, 20, 30, 60, or 120 min. Relaxation of isolated SMA vascular rings to the endothelium-dependent vasodilator ACh was unimpaired following 120 min of ischemia (86 +/- 5%); however, significant (P < 0.01) reductions in endothelium-dependent vasorelaxation were observed following 2.5 min (53 +/- 6%) of reperfusion with severe dysfunction (P < 0.001) observed at 20 min (29 +/- 4%). Neutrophil adherence to the endothelium increased as a function of reperfusion time with a 2.3-fold increase observed at 20 min (P < 0.01) and a 3.4-fold increase observed at 120 min (P < 0.001). Intestinal myeloperoxidase activity was significantly increased 30 min after reperfusion (P < 0.05), whereas surface expression of P-selectin progressively increased at 5 (P < 0.05) and 30 min (P < 0.001) postreperfusion. These findings demonstrate that endothelial dysfunction is a very early event in the pathophysiology of SAO/R, subsequently resulting in increased surface expression of P-selectin and the adherence of neutrophils to the endothelium that leads to neutrophil accumulation in the splanchnic viscera.