What You Need to Know About Necrotizing Pancreatitis

The pancreas is a gland located near the stomach that performs two critical digestive functions: Making insulin and another hormone called glucagon (to balance blood sugars) and producing digestive enzymes.

Pancreatitis is due to inflammation of the pancreas caused by damage from digestive enzymes. Necrotizing pancreatitis is a severe form of pancreatitis in which at least one-third of the pancreas is severely inflamed and nonfunctioning.

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

Pancreas cancer, computer illustration.

SEBASTIAN KAULITZKI / SCIENCE PHOTO LIBRARY

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.

Pancreatitis Statistics

It is estimated that acute pancreatitis, meaning it's sudden and short-lived, causes 275,000 hospitalizations a year; chronic (long-lasting) pancreatitis leads to 86,000 hospitalizations a year.

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:

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.

Frequently Asked Questions

  • How painful is necrotizing pancreatitis?

    Acute pancreatitis is often painful and is a main reason people seek care at emergency departments. Necrotizing pancreatitis is a more severe form of acute pancreatitis. Pain management is an integral part of treatment for acute and necrotizing pancreatitis.

  • Is necrotizing pancreatitis lethal?

    It can be. Necrotizing pancreatitis accounts for about 5% to 10% of all pancreatitis conditions. Due to extensive infection and inflammation, necrotizing pancreatitis is considered to have a mortality rate (rate of death) of around 20% to 30%.

  • What does the pancreas do?

    The pancreas is an organ located near the stomach, at the top of the small intestine. It has two main functions within the digestive system. These functions include releasing digestive enzymes to break down food and releasing insulin to manage the amount of glucose circulating within the body's blood.

  • What should you avoid if you have pancreatitis?

    If you are diagnosed with pancreatitis, you should avoid irritants such as alcohol, tobacco, and high-fat foods.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Institute of Diabetes and Digestive and Kidney Diseases. Definitions and facts for pancreatitis.

  2. Boumitri C, Brown E, Kahaleh M. Necrotizing pancreatitis: current management and therapies. Clin Endosc. 2017;50(4):357-365. doi:10.5946/ce.2016.152

  3. National Institute for Diabetes and Digestive and Kidney Diseases. Symptoms and causes of pancreatitis.

  4. National Institute of Diabetes and Digestive and Kidney Diseases. Diagnosis of pancreatitis.

  5. National Institute for Diabetes and Digestive and Kidney Diseases. Treatment for pancreatitis.

By Pamela Assid, DNP, RN
Pamela Assid, DNP, RN, is a board-certified nursing specialist with over 25 years of expertise in emergency, pediatric, and leadership roles.