Necrotizing Pancreatitis: Causes, Symptoms, and Treatments

Medically Reviewed By Cynthia Taylor Chavoustie, MPAS, PA-C
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Necrotizing pancreatitis occurs when pancreatic or peripancreatic necrosis develops as a result of acute pancreatitis. It is a potentially fatal condition. Necrosis refers to the death of tissue due to a loss of blood supply. This can happen in the pancreas as a result of inflammation. Necrotized tissue is also more likely than other types of tissue to become infected, which can result in infected necrotizing pancreatitis.

This article looks at necrotizing pancreatitis in more detail, including its causes, symptoms, risk factors, diagnosis, treatment, and prevention.

What causes necrotizing pancreatitis?

A man is lying in bed with his hand on his stomach.
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Necrotizing pancreatitis typically occurs as a result of the inflammation present in acute pancreatitis.

Inflammation can cause a reduction in the blood supply to the pancreas. This loss of blood supply can cause the tissue in the pancreas to die.

Inflammation can also cause enzymes to leak into the tissue. These enzymes can then kill the tissue.

The main causes of acute pancreatitis are gallstones and excessive alcohol consumption. Other possible causes include:

Learn more about necrosis.

What are the symptoms of necrotizing pancreatitis?

The main symptom of necrotizing pancreatitis is abdominal pain, which can come on suddenly or develop slowly.

Other symptoms you may experience with necrotizing pancreatitis include:

  • nausea
  • vomiting
  • fever
  • dehydration
  • rapid heart rate

Learn about the symptoms of pancreatitis.

What are the treatments for necrotizing pancreatitis?

Necrotizing pancreatitis is a possible complication of acute pancreatitis that can be severe. Treatment is essential.

The aims of treatment for necrotizing pancreatitis include:

  • reducing the risk of infection
  • treating any existing infections with antibiotics
  • draining the infection
  • removing dead tissue

Endoscopic necrosectomy

Endoscopic necrosectomy involves inserting an instrument called an endoscope through the mouth down into the stomach or the first part of the small intestine, which is called the duodenum. An endoscope is a thin, flexible tube with a camera and an opening for tools on the end of it. It allows the doctor to view your internal organs and check for dead tissue on the pancreas.

A surgeon can then make an incision in the stomach wall to remove the dead tissue.

Open necrosectomy

You may require an open necrosectomy if you develop necrotizing pancreatitis with a secondary infection or if the tissue is hard to get to using an endoscope.

However, as there are various possible complications of open necrosectomy, your surgeon may first try to remove the tissue using minimally invasive surgery. They will be able to provide you with more details about the specific procedure they recommend.

When should I see a doctor?

It is important to contact a doctor as soon as you have concerns about acute pancreatitis or necrotizing pancreatitis.

Pancreatic necrosis can potentially be fatal, so receiving an accurate diagnosis and beginning treatment as early as possible is crucial.

How do doctors diagnose necrotizing pancreatitis?

If the doctor suspects necrotizing pancreatitis, they will likely take a full medical history and carry out a physical examination.

They may then order various tests to assist with confirming the diagnosis. These tests may include:

  • Blood tests: Doctors can use these to check for elevated pancreatic enzymes.
  • Abdominal X-rays: These imaging tests allow doctors to examine the tissue.
  • Other imaging tests: Examples include ultrasound, CT, and MRI scans.
  • Magnetic resonance cholangiopancreatography: Doctors can use this to examine the pancreas, the gallbladder, and the pancreatic and biliary ducts.

The doctor will be able to explain the tests they recommend in more detail and answer any questions you may have.

How common is necrotizing pancreatitis?

Necrotizing pancreatitis is a relatively rare but serious possible complication of acute pancreatitis.

Acute pancreatitis is responsible for close to 270,000 hospital admissions in the United States each year.

About 5–10% of people with acute pancreatitis will develop necrotizing pancreatitis.

What are the risk factors for necrotizing pancreatitis?

Certain risk factors may make you more likely to develop severe pancreatitis, which can result in necrotizing pancreatitis.

These risk factors include:

What are the complications of necrotizing pancreatitis?

Necrotizing pancreatitis is a potentially life threatening complication of acute pancreatitis.

It typically occurs in cases of severe acute pancreatitis, which has a mortality rate of more than 30%.

It is important to contact a doctor as soon as you experience symptoms of acute pancreatitis. This will help ensure that you receive an accurate diagnosis and begin treatment as early as possible to reduce your risk of complications.

The symptoms of acute pancreatitis include:

  • severe abdominal pain that occurs suddenly in the center of your abdomen
  • swollen or tender stomach
  • vomiting or feeling sick
  • indigestion
  • high temperature or fever
  • rapid breathing
  • fast heartbeat
  • yellowing of the skin and the whites of the eyes

Can I prevent necrotizing pancreatitis?

You can take steps to reduce your risk of developing acute pancreatitis, which can lead to necrotizing pancreatitis.

For instance, consuming a nutritious, balanced diet can help reduce your risk of gallstones.

Moderating or avoiding alcohol consumption can also lower your risk of acute pancreatitis.

If you do develop acute pancreatitis, it is important to follow your treatment plan to help prevent necrotizing pancreatitis and infection.

Contact your doctor for more advice on how to reduce your risk of pancreatitis.


Necrotizing pancreatitis is a potentially fatal complication of acute pancreatitis. It occurs when tissue in the pancreas dies due to enzymes leaking into the tissue or a loss of blood flow.

The main symptom of necrotizing pancreatitis is abdominal pain. You may also experience nausea and vomiting, fever, dehydration, and a rapid heart rate.

It is important to contact a doctor as soon as you have concerns about acute pancreatitis or necrotizing pancreatitis. The doctor will be able to carry out tests to confirm the diagnosis and advise on the right treatments for you.

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Medical Reviewer: Cynthia Taylor Chavoustie, MPAS, PA-C
Last Review Date: 2022 Sep 16
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