Necrotizing pancreatitis
Updates to Article Attributes
Necrotising pancreatitis (NP) represents the severe form of pancreatitis. It is generally considered a subtype of acute pancreatitis as necrosis usually tends to occurs early, (within the first 24-48 hours) but can also rarely occur with subacute forms.
A key feature is a significant amount of pancreatic and/or peripancreatic tissue necrosis associated with pancreatitis.
Epidemiology
Around 5-10% of patients with interstitial oedematous pancreatitis (i.e. uncomplicated acute pancreatitis) will develop necrosis 5.
Pathology
NP can become infected, more commonly after the first week.
Radiographic features
NP presents most commonly as necrosis affecting both the pancreas and peripancreatic tissues. Rarely it will affect only the peripancreatic tissues or pancreas in isolation 5.
CT
Areas of necrosis are seen as non-enhancing low attenuating regions within the pancreas, but observed if a dual phase pancreatic study is performed.
Foci of gas may also be present in more extreme cases; extra-luminal gas is highly suggestive of superimposed infection.
Treatment and prognosis
The presence of necrosis implies a poorer prognosis with mortality rates reported up to 14% 3.
-<p><strong>Necrotising pancreatitis (NP)</strong> represents the severe form of <a href="/articles/pancreatitis">pancreatitis</a>. It is generally considered a subtype of acute pancreatitis as necrosis usually tends to occurs early, (within the first 24-48 hours) but can also rarely occur with subacute forms.</p><p>A key feature is a significant amount of pancreatic and/or peripancreatic tissue necrosis associated with pancreatitis.</p><h4>Epidemiology</h4><p>Around 5-10% of patients with interstitial oedematous pancreatitis (i.e. uncomplicated acute pancreatitis) will develop necrosis <sup>5</sup>. </p><h4>Pathology</h4><p>NP can become infected, more commonly after the first week. </p><h4>Radiographic features</h4><p>NP presents most commonly as necrosis affecting both the pancreas and peripancreatic tissues. Rarely it will affect only the peripancreatic tissues or pancreas in isolation <sup>5</sup>.</p><h5>CT</h5><p>Areas of necrosis are seen as non-enhancing low attenuating regions within the pancreas, but observed if a dual phase pancreatic study is performed. Foci of gas may also be present in more extreme cases; extra-luminal gas is highly suggestive of superimposed infection. </p><h4>Treatment and prognosis</h4><p>The presence of necrosis implies a poorer prognosis with mortality rates reported up to 14% <sup>3</sup>.</p>- +<p><strong>Necrotising pancreatitis (NP)</strong> represents the severe form of <a href="/articles/pancreatitis">pancreatitis</a>. It is generally considered a subtype of acute pancreatitis as necrosis usually tends to occurs early, (within the first 24-48 hours) but can also rarely occur with subacute forms.</p><p>A key feature is a significant amount of pancreatic and/or peripancreatic tissue necrosis associated with pancreatitis.</p><h4>Epidemiology</h4><p>Around 5-10% of patients with interstitial oedematous pancreatitis (i.e. uncomplicated acute pancreatitis) will develop necrosis <sup>5</sup>. </p><h4>Pathology</h4><p>NP can become infected, more commonly after the first week. </p><h4>Radiographic features</h4><p>NP presents most commonly as necrosis affecting both the pancreas and peripancreatic tissues. Rarely it will affect only the peripancreatic tissues or pancreas in isolation <sup>5</sup>.</p><h5>CT</h5><p>Areas of necrosis are seen as non-enhancing low attenuating regions within the pancreas, but observed if a dual phase pancreatic study is performed.</p><p>Foci of gas may also be present in more extreme cases; extra-luminal gas is highly suggestive of superimposed infection. </p><h4>Treatment and prognosis</h4><p>The presence of necrosis implies a poorer prognosis with mortality rates reported up to 14% <sup>3</sup>.</p>
Image 6 CT (C+ portal venous phase) ( update )
Image 7 CT (non-contrast) ( update )
Unable to process the form. Check for errors and try again.