Necrotizing pancreatitis: diagnosis and management.

Necrotizing pancreatitis is a severe disease characterized by gland necrosis and a destructive systemic inflammatory response. Early management involves aggressive resuscitative and supportive measures. Outcomes are primarily determined by the presence of late secondary bacterial infection of the necrotic gland. Early empiric antibiotics and late surgical necrosectomy in the appropriate setting are the keys to managing these sick patients. With appropriate management, mortality can be minimized and long-term quality of life may be restored.