Walled-Off Necrosis in Acute Pancreatitis: Clinical and Therapeutic Implications

Abstract

Acute pancreatitis still represents a challenge for physicians; it ranges from mild self-limiting forms Walled-off necrosis (WON), previously called by other names, such as organized pancreatic necrosis, necroma, pancreatic sequestration, pseudocyst associated with necrosis and subacute pancreatic necrosis is a new entity of complications of acute pancreatitis. It is defined as a mature, encapsulated collection of pancreatic and/or peripancreatic necrosis which has developed a well-defined inflammatory wall. WON usually occurs >4 weeks after the onset of necrotizing pancreatitis. However, it derives from the necrotic pancreatic parenchyma and/or necrotic peripancreatic tissues, and may be sterile or infected, single or multiple, and present at sites distant from the pancreas. In this paper, the current data regarding WON as to its definition, diagnosis and treatment will be narratively reviewed.