What to Know About Necrotizing Pancreatitis

Medically Reviewed by Minesh Khatri, MD on September 10, 2023
3 min read

The pancreas performs vital functions in your body. It helps in digestion and creates insulin to maintain your blood sugar. Certain conditions and lifestyle choices can damage the pancreas and lead to pancreatitis — or the inflammation of the pancreas.

Necrotizing pancreatitis is a serious result of acute pancreatitis. If the damage done to your pancreas is too severe, part of the pancreas actually dies (called necrosis).

You have pancreatitis when your pancreas becomes inflamed. This happens when the digestive chemicals produced by the pancreas get mixed up and start digesting the pancreas itself.

There are two types of pancreatitis — acute and chronic. Both are serious and require treatment.

Acute pancreatitis. This type is sudden and goes away quickly with treatment. Acute pancreatitis is the most common form, and it’s also the most common cause of necrotizing pancreatitis.

Chronic pancreatitis. Chronic pancreatitis is long-lasting. Your pancreas doesn’t heal and worsens with time. Chronic pancreatitis causes permanent damage to your pancreas, but it doesn’t lead to necrotizing pancreatitis very often.

Complications. There are many ways pancreatitis can get worse. Repeated attacks of acute pancreatitis can become chronic pancreatitis. Chronic pancreatitis can lead to the development of conditions like diabetes or cancer.

Necrosis happens when a tissue in your body dies due to lack of blood flow, injury, or disease.  Necrosis is permanent, making it a serious complication of pancreatitis.

Necrotizing pancreatitis happens when the inflammation and damage from pancreatitis cause tissue in the pancreas to die — or necrotize. Necrotizing pancreatitis has a range of severity, but complications of necrosis are serious. Symptoms and treatment options will depend on how severe the necrosis is.

Necrotizing pancreatitis is a result of pancreatitis. Most commonly, the sudden damage caused by acute pancreatitis can lead to necrosis of the pancreas.

People at risk for acute pancreatitis are similarly at risk for necrotizing pancreatitis. The most common causes are gallstones and drinking too much alcohol. Necrotizing pancreatitis can also be caused by:

  • Trauma and damage to the pancreas
  • High levels of calcium
  • High levels of cholesterol
  • Pancreatic tumors
  • Autoimmune conditions
  • Genetic conditions that harm your pancreas

The symptoms of necrotizing pancreatitis are similar to those of acute pancreatitis. The necrosis in your pancreas can be benign, causing no harm to you. However, certain germs and bacteria can spread to the rest of your pancreas and cause further complications.

Symptoms of acute pancreatitis include:

  • Slow or gradual pain in your upper abdomen (the pain can extend to your back)
  • Fever
  • Swollen abdomen
  • Nausea
  • Vomiting

Worsening symptoms can suggest severe pancreatitis — which increases the chances of necrosis. Severe symptoms to look out for are:

  • Chills
  • Quickened heartbeat
  • Shortness of breath
  • Jaundice (yellow tint of your skin or eyes)

Early detection and treatment are crucial in preventing complications. If necrotizing pancreatitis is left untreated, it can be fatal.

Infection can happen in your pancreas around 2 or 3 weeks after necrosis sets in. This can lead to sepsis, a severe response to bacteria that can lead to shock. Shock damages your organs, potentially leading to death.

Methods of diagnosing pancreatitis include:

  • Tests for pancreatic enzymes in your bloodstream
  • Tests to narrow down the cause of your pancreatitis
  • Imaging tests on your abdomen

If you have necrotizing pancreatitis, your doctor may use another imaging test to check for infection. Your doctor may also take a small sample of the dead tissue in the pancreas to check for signs of infection.

The first step is to treat your pancreatitis. Treatment options include:

  • Bed rest
  • Intravenous (IV) fluids
  • Pain relievers
  • Medications that prevent nausea and vomiting
  • Liquid nutrition through a feeding tube

After the pancreatitis is under control, the dead tissue will be examined for infection. If there’s no sign of infection, no further treatment may be needed.

Infected tissue requires antibiotics. The dead tissue will also likely be surgically removed to prevent the infection from spreading. If you’re stable, treatment for necrotizing pancreatitis might be delayed to avoid serious complications.

Keep your pancreas healthy. This will lower your risk of pancreatitis in the first place and help you avoid complications like necrosis.

You can’t totally prevent pancreatitis. But, certain lifestyle changes will help you stay healthy and lower your risk:

  • Avoid excessive alcohol
  • Don’t smoke
  • Stay at a healthy weight