What Is Necrotizing Pancreatitis and How Is It Treated?

Medically reviewed by Alana Biggers, MD on August 10, 2017Written by James Roland

Is this cause for concern?

Necrotizing pancreatitis is an extreme complication of acute pancreatitis. Acute pancreatitis is an inflammation of the pancreas.

Your pancreas sits behind your stomach. One of its main jobs is to make enzymes that help you digest food. Normally, those enzymes flow through a small opening into your small intestines.

If your pancreas becomes inflamed, the enzymes can start to leak into parts of the pancreas instead. These enzymes can sometimes kill pancreatic tissue, resulting in necrotizing pancreatitis. The dead tissue can get infected and cause life-threatening complications. Medication and removal of the dead tissue are usually necessary.

Keep reading to learn more about why this happens, symptoms to watch for, and more.

What causes necrotizing pancreatitis to develop?

Necrotizing pancreatitis occurs when acute pancreatitis is left untreated or isn’t treated correctly. Most pancreatitis diagnoses result from excessive alcohol consumption and gallstones.

Pancreatitis may also result from:

In rare cases, necrotizing pancreatitis affects people with chronic pancreatitis. Chronic pancreatitis is a long-term condition, whereas acute cases are temporary episodes of inflammation.

What are the symptoms?

Abdominal pain is one of the main symptoms of necrotizing pancreatitis. It can build slowly or come on quickly. Severe pain can be felt in front, near your stomach, and also wrap around your back. The pain may last for several days.

The pain may also become worse after eating, and your abdomen may become swollen.

Other common symptoms include:

  • fever
  • nausea
  • vomiting
  • dehydration
  • rapid heart rate

How is it diagnosed?

Diagnosing necrotizing pancreatitis starts with a review of your symptoms and medical history. After your doctor performs a physical examination, they may order diagnostic testing to rule out other possible causes.

Imaging tests typically include:

They may also order blood tests that check for:

  • pancreatic enzymes
  • sodium
  • potassium
  • glucose
  • cholesterol
  • triglycerides

If an imaging test reveals that a portion of your pancreatic tissue has died, your doctor will want to remove some of the tissue for analysis. To do this, your doctor will inject a fine needle into your pancreas to extract a small piece of tissue. They’ll test this tissue for signs of infection.

What treatment options are available?

Necrotizing pancreatitis requires a two-fold approach to treatment. The pancreatitis must be controlled, and the dead tissue may need to be removed.

An acute attack of pancreatitis requires rest and fluids, often administered with an IV. Painkillers may be necessary. You may also need medications to control nausea and vomiting. In some cases, you may need to have nutrition given in liquid form. This is sometimes done using a long tube that runs through your nose into your stomach.

If the tissue that was removed shows signs of infection, you’ll need antibiotics. You may also need to have the dead tissue removed. If no infection is present, removing the dead tissue may not be necessary. Talk with your doctor about the risks and benefits associated with leaving the dead tissue alone versus removing it.

If removal is recommended, your doctor can extract the dead tissue using a catheter or endoscopic procedure. If these minimally invasive procedures aren’t enough, your doctor may suggest open surgery to remove the tissue.

Any other type of procedure you’ve had scheduled may be put off a few weeks. The initial goal is to get your pancreatitis under control.

Outlook

Necrotizing pancreatitis is treatable, but the risk of serious infection is real. It’s important to follow your doctor’s recommendations to prevent additional complications.

If you’re proactive about treatment, you’ll likely live a long, healthy life after an episode of necrotizing pancreatitis. Your doctor may advise lifestyle changes, such as avoiding alcohol, to help reduce your risk of future problems.

Can pancreatitis be prevented?

It’s not always possible to prevent acute pancreatitis or a complication such as necrotic pancreatitis.

Still, there are a few things you can do to improve pancreatic health:

If you have symptoms of acute pancreatitis, get medical attention. Work with your doctor to keep it from progressing. You may be able to avoid the necrotizing stage of the disease.

CMS Id: 129967