Necrotizing pancreatitis occurs when acute pancreatitis becomes very severe, leading to death (necrosis) of pancreatic tissue due to inflammation and lack of blood flow (ischemia). This condition typically develops as a progression from acute pancreatitis, where the inflammation is so intense that pancreatic enzymes activate prematurely inside the pancreas, digesting the tissue itself and causing damage

. The main causes of necrotizing pancreatitis include:

• Gallstones : The leading cause, accounting for up to 80% of cases. Gallstones can block the bile or pancreatic duct, triggering enzyme activation and inflammation

• Excessive alcohol consumption : Chronic heavy drinking causes pancreatic inflammation and damage, increasing risk

• Other causes : Trauma to the pancreas, high blood levels of calcium (hypercalcemia) or triglycerides (hypertriglyceridemia), pancreatic tumors, certain medications, autoimmune diseases, genetic conditions affecting the pancreas, and infections

Risk factors that increase the likelihood of severe pancreatitis progressing to necrotizing pancreatitis include obesity, smoking, older age (over 70), family history of pancreatitis, and drinking multiple alcoholic drinks daily

. In summary, necrotizing pancreatitis results from severe acute pancreatitis caused mainly by gallstones or alcohol abuse, leading to pancreatic tissue death due to enzyme activation, inflammation, and impaired blood flow