Necrotizing pancreatitis is a severe complication of acute pancreatitis, caused by alcoholism or gallstones. It can lead to death of tissue and infection, potentially causing organ failure. Treatment involves monitoring or surgery, with a survival rate of about two-thirds.
Necrotizing pancreatitis is a condition that sometimes develops as a complication of acute pancreatitis. The pancreas is a gland of the digestive system. Alcoholism or gallstones can lead to the development of acute pancreatitis, in which the pancreas suddenly becomes inflamed. In some cases, the inflammation of the pancreas is severe and this can lead to the death of areas of tissue in and around the pancreas, in what is known as necrotizing pancreatitis. Areas of necrotic, or dead, tissue can then become infected and this can be associated with the failure of a number of organs in the body, with fatal consequences.
Within the digestive system, the function of the pancreas is to produce hormones and digestive juices, as well as the hormone insulin. Excessive alcohol consumption 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 can suddenly flare up and worsen into an acute attack. Digestive enzymes in pancreatic cells begin digesting the pancreas, and the inflammation can spread to other organs, leading to death in severe cases. About one-third of people who survive a severe attack of pancreatitis may develop necrotizing pancreatitis, with necrosis or death of areas of the pancreas and surrounding tissue, often followed by infection.
When a pancreatitis attack does not respond to treatment, necrotizing pancreatitis may be suspected. Symptoms of necrotizing pancreatitis might include abdominal pain, tenderness, and fever. The pancreas may be enlarged and it may be possible to feel it in the upper abdomen. A computed tomography, or CT scan, can reveal fluid-filled areas within the gland. Samples can be taken from the pancreas using a fine needle attached to a syringe to determine if necrosis and bacteria are present.
Treatments for necrotizing pancreatitis vary depending on whether the necrotic tissue has become infected. In the absence of infection, patients are monitored closely and antibiotics may be given as a preventative measure. If the necrotic areas of the pancreas have already become infected, surgery is required.
Surgical treatment involves a procedure known as a necrosectomy, in which dead tissue is removed, fluid is drained, and the diseased area is washed. Necrotizing pancreatitis is a serious condition and, even with appropriate treatment, only about two-thirds of patients are expected to survive. The outlook is better in cases where no infection has occurred.
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