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Necrotizing Pancreatitis

WHAT IS NECROTIZING PANCREATITIS?

Necrotizing pancreatitis is an extreme complication of acute pancreatitis.

If the pancreas becomes inflamed, enzymes can leak into the pancreas. These enzymes can kill pancreatic tissue. This is referred to as necrotizing pancreatitis.

At Loma Linda University Health, treatment for necrotizing pancreatitis is provided by board-certified gastroenterologists and surgeons. Our digestive disease specialists work together to treat complex pancreas and biliary conditions with a single team approach.

WHAT ARE THE SYMPTOMS OF NECROTIZING PANCREATITIS?

One of the main symptoms of necrotizing pancreatitis is abdominal pain. It can be sudden pain, or it can come on slowly. Severe pain can be felt in front, near your stomach, and sometimes wraps around your back. The pain may last for several days. The pain may become worse after eating, and the belly may become swollen.

Other common symptoms include:

  • Fever
  • Nausea
  • Vomiting
  • Dehydration
  • Rapid heart rate

WHAT CAUSES NECROTIZING PANCREATITIS?

Necrotizing pancreatitis can happen when acute pancreatitis is left untreated or isn’t treated correctly. In rare cases, necrotizing pancreatitis can affect people with chronic pancreatitis.

HOW IS NECROTIZING PANCREATITIS DIAGNOSED?

Necrotizing pancreatitis is diagnosed by:

  • Medical history
  • A physical exam
  • Blood tests to check for pancreatic enzymes, sodium, potassium, glucose, cholesterol and triglycerides
  • Imaging studies such as abdominal ultrasound and CT scans

Loma Linda University Health offers the full range of diagnostic options, including:

  • Blood tests, which may reveal elevated pancreatic enzymes
  • Abdominal x-rays, which provide images of internal tissues, bones, and organs  
  • Ultrasound to see the internal organs of the belly and check how blood is flowing through different blood vessels
  • Computed tomography (CT) scan or magnetic resonance imaging (MRI)  
  • Magnetic resonance cholangiopancreatography (MRCP) to make detailed images of your pancreas, gallbladder, and the pancreas and biliary ducts
  • Endoscopic ultrasound (EUS) to evaluate the pancreas during sedation

HOW IS NECROTIZING PANCREATITIS TREATED?

The majority of patients with necrotizing pancreatitis will be treated conservatively. The emphasis of conservative treatment is on supportive measures and prevention of infection of necrosis and other complications.

Medical treatment

Antibiotics are required, and drainage of the necrotic area may also be necessary.

Surgery

If the dead pancreatic tissue becomes infected, surgery is typically necessary. The procedure normally involves using a catheter to drain fluids, followed by an endoscopic necrosectomy.

At Loma Linda University Health, necrotizing pancreatitis is treated with a customized care plan for the individual patient. The gastroenterologists and surgeons at our Digestive Disease Center work together with other specialists on the healthcare team to treat complex pancreas and biliary conditions in a single team approach.

WHAT ARE THE COMPLICATIONS OF NECROTIZING PANCREATITIS?

If left untreated, dead pancreatic tissue can become infected and cause life-threatening complications.

WHO IS AT RISK FOR NECROTIZING PANCREATITIS?

People most at risk for developing necrotizing pancreatitis are those who suffer from acute pancreatitis. At a lesser risk are those who suffer from chronic pancreatitis.

NEXT STEPS

  • Stay aware. If you have an acute pancreatitis or chronic pancreatitis diagnosis, you are in the risk category for necrotizing pancreatitis. Stay aware of the symptoms of this condition and seek medical intervention immediately if you begin experiencing them. 
  • Be proactive. Pancreatic conditions are serious. To request an evaluation at Loma Linda University Health for pancreatic symptoms, contact your provider or schedule the appointment through MyChart.