What You Need to Know About Necrotizing Pancreatitis

Inflammation of the pancreas caused by damage from digestive enzymes can lead to a condition called pancreatitis. When at least one-third of the pancreas becomes severely inflamed and nonfunctioning, the condition has progressed to a severe form called necrotizing pancreatitis.

This article will discuss what necrotizing pancreatitis is, its causes, symptoms, treatment, and more.

What Is Necrotizing Pancreatitis?

Necrotizing pancreatitis is a severe form of acute pancreatitis. The condition is diagnosed once 30% of the pancreas is considered "dead" or nonfunctioning. Around 5% to 10% of all pancreatitis cases are necrotizing.

Causes and Risk Factors

Before being diagnosed with necrotizing pancreatitis, you must have pancreatitis. Although anyone can be affected by pancreatitis, some groups are more likely to be diagnosed than others:

• Men
• African Americans
• Individuals who have a family history of pancreatitis or a personal/family history of gallstones

There are also several health conditions that increase the risk of pancreatitis or necrotizing pancreatitis:

• Diabetes
• Gallstones
• High triglycerides
• Genetic disorders of the pancreas
• Certain autoimmune conditions
• Cystic fibrosis
• Obesity
• Heavy alcohol use
• Tobacco use
  

Symptoms

Most people with pancreatitis have pain in the center or right side of the upper abdomen, usually right below the ribs. People affected by pancreatitis might also complain about pain in the back, just below the shoulder blades.

If affected by acute pancreatitis, additional symptoms might include:

• Fever
• Nausea and vomiting
• Fast heartbeat
• Tender or swollen abdomen

Those with chronic pancreatitis may have different symptoms as their bodies adjust to living with this chronic condition. These symptoms include:

• Constant and severe pain that worsens after eating
• Diarrhea
• Nausea
• Foul-smelling, greasy stools due to lack of digestive enzymes produced by the inflamed pancreas
• Fast heartbeat
• Shortness of breath due to swelling of the abdomen
• Jaundice, which causes a yellowing of the skin and white parts of the eyes
  

Diagnosis 

If you suspect you have pancreatitis, you must see your healthcare provider as soon as possible so they can get your complete medical history and perform a physical examination.

Pancreatitis can have similar symptoms as other digestive conditions, such as peptic ulcers or pancreatic cancer, so ordering laboratory or imaging tests might be needed.

Specific laboratory and imaging tests ordered to determine if you have pancreatitis include:

• Amylase and lipase: Tests for higher levels of these digestive enzymes in the bloodstream
• Blood glucose: Indicates blood glucose (sugar in the blood) levels, which may indicate a problem with insulin production
• Lipid panel: Tests for elevated triglycerides (a type of fat)
• Complete blood count (CBC): Monitors the body's response to a possible infection via white blood cell readings and can assist healthcare providers in diagnosing necrotizing pancreatitis early and preventing the condition from worsening
• Ultrasound and computed (CT) tomography: Imaging tests that can locate inflammation, infection, or blood flow of the pancreas and surrounding organs

Often, people with pancreatitis and necrotizing pancreatitis are very ill and need to seek immediate medical attention. Testing can be completed in the emergency room for a rapid diagnosis and early treatment.

Treatment

A necrotizing pancreatitis diagnosis requires immediate and aggressive intravenous fluid to account for the liquid lost from pancreatic inflammation and to ensure proper hydration while abstaining from eating or drinking.

The pancreas releases digestive enzymes any time you eat or drink. Abstaining from eating and drinking allows the pancreas to heal from inflammation rather than producing enzymes to break down food.

Antibiotics help the body fight infections and prevents additional damage to the pancreas. Pain management is also a vital part of treatment.

With proper hydration, intravenous nutrition, antibiotic administration, and pain management, around two-thirds of people with necrotizing pancreatitis recover without additional intervention. Surgery is usually needed for the one-third that do not get better to clear out any associated infection and allow the pancreas time to heal.

Tips to Prevent Pancreatitis 

Activities and habits that increase the risk of pancreatitis and necrotizing pancreatitis by making the pancreas harder include:

• Being inactive
• Drinking alcohol
• Using tobacco
• Eating a high-fat diet

Summary

Necrotizing pancreatitis is a severe form of pancreatitis diagnosed when 30% of the pancreas is considered "dead" or no longer functioning. It's essential to get immediate medical attention when you experience the symptoms of pancreatitis. These symptoms include sudden upper abdominal or back pain accompanied by nausea, vomiting, or fever.

Treatment includes proper hydration, intravenous nutrition, antibiotics as needed, and pain management. You can minimize your risk of pancreatitis by avoiding heavy use of alcohol or tobacco.

A Word From Verywell 

Necrotizing pancreatitis is a severe illness and requires immediate medical attention. If you or someone you know is experiencing symptoms of pancreatitis, contact your healthcare provider or go straight to a hospital emergency room. Once you're aware of your condition, you and your healthcare provider can determine the best treatment plan for you.