Acute pancreatitis is a relatively common disease and presents a great variety of morphologic and clinical manifestations which range from a mild transitory illness to a fatal outcome. As a result of great improvemonts in supportive and intensive
care,
the morbidity and mortality of acute pancreatitis have been decreased. But in necrotizing pancreatitis, there were still many difficult problems in the management, and even surgical treatment is frequently required. During the periods between
992.
1 and
1994. 12. 31, we experienced 12 cases of necrotizing pancreatitis, and we evaluated various clinical features of the cases. The peak incidence was sixth decades(25.0%, 4 cases) and the male to female ratio was 1:1.4. The etiology of pancreatitis
was
unknown in 50.0%(7 cases), alcoholism in 25.0%(3 cases), and trauma in 16.7%(2 cases). Abdominal pain and tenderness were the most common symptoms (12 cases, 100%) and nausea and/or vomiting, fever (8 cases, 66.7%), and abdominal distension(7
cases,
58.3%) were presented in the order named. Comparative accuracy of diagnostic methods were abdominal CT in 100% and ultrasonogram in 75.0%. The preoperative diagnostic rate of necrotizing pancreatitis was 58.3%(7 cases) and the other preoperative
diagnosis were ulce perforation(3 cases) and aucte appendicitis(1 case). As for the methods of the surgical treatment, Irrigation and drainage was done in 7 cases (50%), necrosectomy with Irrigation and drainage was done in 2 cases(16.7%),
gastrostomy
and jejunostomy with irrigation and drainage was done in 3 cases(25.0%). Two cases died due to sepsis, and postoperative complications consisted of intraabdominal abscess in 4 cases(33.3%), pulmonary insufficiency in 4 cases(33.3%), pseudocyst in
2
cases(16.7%), renal insufficiency in 2 cases(16.7%) and pancreas-colonic fistula in 1 case(8.3%).
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