- What Is It?
- 4 Causes
Necrotizing pancreatitis is a serious complication in cases of acute pancreatitis and must always be treated in a hospital.
Necrotizing pancreatitis is diagnosed with computed tomography or magnetic resonance imaging scans and treated with antibiotics and aggressive interventions.
In some cases, healthcare providers may remove the dead and infected pancreatic tissue via a process called endoscopic retrograde cholangiopancreatography.
Healthcare professionals treat necrotizing pancreatitis in two stages. Firstly, they treat pancreatitis by giving medications. Then, the dead part of the pancreas is managed via interventions.
5 treatments for pancreatitis
- Intravenous (IV) fluids
- Pain-relieving medication
- Medication to prevent nausea and vomiting
- Nasogastric feeding (A person is fed liquid food through a tube in their nose. Feeding a person in this way gives the pancreas rest from producing digestive enzymes, which set up a destructive cascade of events that ultimately destroy abdominal organs.)
Treating dead or infected pancreatic tissue
The second stage of treatment for necrotizing pancreatitis targets the dead part of the pancreas.
Healthcare professionals may need to remove the dead tissue. If the tissue is infected, the doctor will prescribe antibiotics.
To remove dead pancreatic tissue, the doctor may insert a thin tube called a catheter into a person’s abdomen. They will remove the dead tissue through this tube. If this does not work, open surgery could be required.
The gold-standard intervention for infected pancreatic necrosis or symptomatic sterile walled-off pancreatic necrosis is exploratory laparotomy. This involves exploratory laparotomy with blunt debridement of all visible necrotic pancreatic tissue.
If a person develops sepsis from an infection causing necrotizing pancreatitis, this could be life-threatening. To treat sepsis, the doctor will prescribe:
- IV medications
- Breathing support
Treating the early signs of infection is the best way to prevent sepsis.
What is necrotizing pancreatitis?
Necrotizing pancreatitis is a severe inflammation of the pancreas, causing tissue death. If the dead tissue gets infected, it can cause severe complications, such as peritonitis (inflammation of the abdominal cavity), septic shock, and multiorgan dysfunction syndrome.
What are the symptoms of necrotizing pancreatitis?
The main symptom of necrotizing pancreatitis is abdominal pain. A person may feel abdominal pain in several places, including:
- At the front of the abdomen
- Near the stomach
- Around the back
10 other symptoms of necrotizing pancreatitis
- Swollen abdomen
- Low blood pressure
- Rapid heart rate
- Shortness of breath
- Jaundice (yellow tint of the skin or eyes)
Necrotizing pancreatitis may lead to a bacterial infection and sepsis if left untreated.
Sepsis is a condition where a person’s body reacts adversely to bacteria in their bloodstream, possibly causing the body to go into shock.
4 causes of necrotizing pancreatitis
- Necrotizing pancreatitis happens when the pancreas gets inflamed or injured, and the pancreatic enzymes leak. This harms the tissues of the pancreas. If this damage cannot be reversed, it causes necrotizing pancreatitis.
- Necrotizing pancreatitis may start after an episode of sudden (acute) pancreatitis. People with chronic pancreatitis can get necrotizing pancreatitis, but this is not common.
- Having gallstones.
- Alcohol consumption.
8 other causes of necrotizing pancreatitis
- Any physical injury to the pancreas
- Pancreatic stone
- Pancreatic tumor
- High levels of calcium in the blood
- Very high levels of blood fats (cholesterol)
- Damage to the pancreas from medicines
- Autoimmune diseases
- Conditions that run in the family that harm the pancreas, such as cystic fibrosis
What are the complications of necrotizing pancreatitis?
Infection can happen to the pancreas about two or three weeks after necrosis starts. This can lead to sepsis, a severe response to bacteria that can lead to shock. The shock damages organs, which ultimately leads to death.
Necrotizing pancreatitis is a potentially fatal disease and leads to serious complications in about 30 percent of patients. These include:
- Insufficient pancreatic enzymes (which can leave the patient unable to digest food)
- Organ failure
- Fistulae (abnormal holes in the walls of bodily structures)
- Internal bleeding
Besides necrotizing pancreatitis, acute pancreatitis can lead to several other life-threatening complications that include:
- Obstruction of the bile or pancreatic ducts
- Leakage from the pancreatic ducts
- Pseudocysts (fluid-filled cavities that may rupture, hemorrhage, or lead to infection)
- Damage to the pancreas
- Pleural effusion (fluid in the lungs)
- Splenic vein thrombosis
How is necrotizing pancreatitis diagnosed?
To diagnose necrotizing pancreatitis, a doctor may examine a person’s abdomen and analyze their history extensively. They may do blood tests to look for:
- Pancreatic enzyme level (amylase, lipase)
- Serum electrolytes
- Blood glucose
- Blood cholesterol
- Blood triglycerides
- Liver function tests
They may use the following tests to look at the pancreas:
- Abdominal ultrasound
- Computed tomography scan
- Magnetic resonance imaging
The doctor may do a biopsy to identify infection and tissue damage in the necrosed part.
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How can necrotizing pancreatitis be prevented?
Keeping the pancreas healthy can lower the risk of pancreatitis and help avoid complications, such as necrosis.
Pancreatitis cannot be prevented. However, certain lifestyle changes will help stay healthy and lower the risk, such as:
- Avoid drinking alcohol
- Do not smoke
- Stay at a healthy weight
- Eat a low-fat diet
It is essential to recognize the symptoms of necrotizing pancreatitis and speak to a doctor immediately. Getting the right diagnosis and treatment at the earliest is the best way to reduce complications.
Without treatment, necrotizing pancreatitis may lead to an infection or sepsis. This can lead to life-threatening organ damage.
Necrotizing pancreatitis is treatable. Treatments target pancreatitis and then, manage dead or infected tissue. With timely, proper treatment, a person who has had necrotizing pancreatitis should make a full recovery.
Making lifestyle changes to improve pancreatic health is the best way to avoid further problems.
Health Solutions From Our Sponsors
WebMD. What to Know About Necrotizing Pancreatitis. https://www.webmd.com/digestive-disorders/what-to-know-about-necrotizing-pancreatitis
Mayo Clinic. Pancreatitis. https://www.mayoclinic.org/diseases-conditions/pancreatitis/symptoms-causes/syc-20360227
Chua TY, Walsh RM, Baker ME, Stevens T. Necrotizing pancreatitis: Diagnose, treat, consult. Cleve Clin J Med. 2017 Aug;84(8):639-648. https://www.ccjm.org/content/84/8/639
Cedars-Sinai. Necrotizing Pancreatitis. https://www.cedars-sinai.org/health-library/diseases-and-conditions/n/necrotizing-pancreatitis.html
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