Diagnosis of necrotizing pancreatitis

The mortality of acute necrotizing pancreatitis remains high. In addition, the extent of necrosis influences the need of operative intervention. Therefore, exact diagnosis of the extent of necrosis is important. In this study, the reliability of diagnosing the pancreatic necrosis was evaluated. Eight patients in whom pancreatic necrosis was confirmed operatively or by autopsy were studied. Six were confirmed to have had extensive necrosis from the specimen, although the degree varied from one to another. There is no distinct classification of pancreatic necrosis based on the actual pathological data. From the reason, a new rating of pancreatic necrosis is proposed. This rating is based on mainly surgical specimens. Improve ment of results of treatment and their comparison between multiple facilities are expect ed in future when relationships between the degree of necrosis and clinical course or mortality/morbidity are analyzed more accurately.