Pancreatic necrosis is a disease in which parts of the pancreas die and can become infected. In most cases, this is a complication of acute pancreatitis.
Understanding pancreatic necrosis
The pancreas is an organ behind the stomach, responsible for producing enzymes that help digest food. Pancreatic necrosis occurs when the pancreatic tissue dies from inflammation. When a person has pancreatic necrosis, the bacteria can spread into dead tissue and cause an infection.
The pancreas plays an essential role in producing good digestion. When the pancreas is healthy, the enzymes produced by it pass into the small intestine. If the pancreas is inflamed, however, these enzymes can leak into the pancreas and damage the tissue, affecting its functions. This process is called pancreatitis.
If the lesions are severe, blood and oxygen cannot reach some parts of the pancreas, leading to tissue death.
Symptoms
The main symptom of pancreatic necrosis is abdominal pain. Some people may experience severe abdominal pain in several places, including:
- in front of the abdomen;
- near the stomach area;
- towards the back of the stomach.
The pain can be sharp and can last up to a few days. Other symptoms that can accompany the pain include:
- swollen abdomen;
- fever;
- nausea;
- vomiting;
- dehydration;
- low blood pressure;
- increased pulse
Pancreatic necrosis can lead to bacterial infection and sepsis if left untreated. Sepsis is a disorder in which a person’s body reacts negatively to bacteria in the bloodstream, causing the patient a shock.
Septic shock can be life-threatening because it reduces blood flow to the most important organs. This may damage them temporarily or permanently. Without proper treatment, sepsis might be a life threatening condition.
Causes
Acute pancreatitis is most of the times caused by biliary calculus. Pancreatitis is inflammation of the pancreas. The most common causes of pancreatitis are excessive alcohol consumption or gallstones. Gallstones are small stones, most often composed of cholesterol, which form in the bile. It may also be caused by lesions of the pancreas, tumors, high calcium levels, various autoimmune diseases, or high levels of bloot fat.
The two main types of pancreatitis are:
- Acute pancreatitis, when the symptoms develop suddenly.
- Chronic pancreatitis, when the symptoms are recurring.
When a person has pancreatitis, digestive enzymes drain into the pancreas. This causes tissue damage and prevents blood and oxygen from reaching those tissues. Left untreated, certain parts of the pancreas may die. Nearby bacteria can then infect dead pancreatic tissue. It is the infection that causes some of the most severe symptoms of pancreatic necrosis.
Treatments
Doctors treat pancreatic necrosis in two stages. First they treat the pancreatitis, and then, separately, the part of the pancreas that died.
Treating pancreatitis
Medicines, including pain killers, can be prescribed to treat pancreatitis. Treatments for pancreatitis include:
- intravenous fluids;
- pain relievers;
- meds to prevent nausea and vomiting;
- using an nasogastric tube.
When using an nasogastric tube, the person is fed with liquid food through a tube in the nose, allowing the pancreas to have some rest from producing digestive enzymes.
Treatment of dead or infected pancreatic tissue
The second stage of treatment for pancreatic necrosis targets the dead part of the pancreas. Most likely, at this point the doctor will remove the dead tissue. If the tissue is infected, he will also prescribe antibiotics.
To remove dead pancreatic tissue, the doctor can insert a thin tube, called a catheter, into the patient’s abdomen, removing dead tissue through this tube. If it does not work, surgery may be required.
According to studies, the best time to perform surgery is 3 or 4 weeks after the disease starts. However, if the patient experiences severe symptoms, surgery to remove dead or infected tissue may occur earlier.
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