Necrotizing pancreatitis is a condition which sometimes develops as a complication of acute pancreatitis. The pancreas is a gland in the digestive system. Alcoholism or gallstones may lead to the development of acute pancreatitis, in which the pancreas suddenly becomes inflamed. In some cases, pancreas inflammation is severe and this can lead to areas of tissue in and around the pancreas dying off, in what is known as necrotizing pancreatitis. The areas of necrotic, or dead, tissue may then become infected, and this can be associated with failure of a number of body organs, with fatal consequences.
Inside the digestive system, the function of the pancreas is to produce digestive hormones and juices, as well as the hormone insulin. Excessive consumption of alcohol or gallstones can lead to inflammation, although the mechanism by which gallstones cause pancreatitis is not fully understood. In the case of alcoholism, people may already have long-term, or chronic, pancreatitis, which may suddenly flare up and become worse in an acute attack. Digestive enzymes in pancreatic cells begin to digest the pancreas, and inflammation may spread to other organs, leading to death in the most severe cases. For around a third of people who survive a severe attack of pancreatitis, necrotizing pancreatitis may develop, with necrosis, or death, of areas of the pancreas and surrounding tissues occurring, often followed by infection.
When an attack of pancreatitis fails to respond to treatment, necrotizing pancreatitis may be suspected. Necrotizing pancreatitis symptoms could include abdominal pain and tenderness and fever. The pancreas may be enlarged and it may be possible to feel it in the upper abdomen. A computerized tomography, or CT, scan may reveal areas full of fluid inside the gland. Samples may be taken from the pancreas using a fine needle attached to a syringe to determine whether necrosis and bacteria are present.
Necrotizing pancreatitis treatments vary depending on whether the necrotic tissue has become infected. Where no infection is present, patients are monitored closely and antibiotics may be given as a preventive measure. If necrotic areas of the pancreas have already been infected, surgery is necessary.
Surgical treatment involves a procedure known as necrosectomy, in which dead tissue is cut away, fluid is drained and the diseased area is washed out. Necrotizing pancreatitis is a serious condition, and even with appropriate treatment only around two-thirds of patients are expected to survive. The outlook is better in cases where infection has not occurred.
