Acute pancreatic necrosis in chronic alcoholic pancreatitis.

Necrotic lesions are rarely observed in chronic pancreatitis, but its presence in a few patients has been misinterpreted in the diagnosis of acute pancreatitis. In this series, 12 patients (11.2%) of 107 operated for chronic alcoholic pancreatitis, presented with acute pancreatic necrosis associated with pancreatic fibrosis characteristic of chronic pancreatitis. Ten patients were treated by pancreatic debridement and drainage and two by distal pancreatic resections. Postoperative complications included five pancreatic fistulas and two pancreatic abscesses. Despite the severity of the pancreatic lesions which led to several complications, all the patients survived. The occurrence of pancreatic necrosis in patients with chronic pancreatitis is demonstrated.