Version July 2025
CT: computed tomography; WBC: white blood cell.
* Necrosis involving the pancreas or peripancreatic tissues within 4 weeks of the onset of pancreatitis (visualized on CT or radiographically). Acute necrotic collections do not have a mature wall.
¶ Signs of infection include clinical deterioration, sepsis, increasing WBC, fevers, failure to improve after 7 to 10 days of hospitalization, or presence of gas within necrosis on imaging. Though previously commonly utilized, CT-guided aspiration is rarely performed to determine the presence of infection.
Δ Local resistance patterns and patient characteristics are factors in antimicrobial selection.
◊ Disconnected duct syndrome: Full transection of the pancreatic duct in the presence of pancreatic necrosis.
§ Refer to UpToDate content on procedural and surgical approaches to pancreatic debridement.
¥ Complications and mortality associated with early intervention (<2 weeks from onset) are high and are performed only in centers with expertise.
