DOI: https://doi.org/10.36347/sasjm.2026.v12i04.011

Pages: 293-295

Necrotizing or necrotico-hemorrhagic acute pancreatitis (PANH) accounts for 10–25% of all forms of acute pancreatitis (AP). It is characterized by high mortality and morbidity, mainly related to the development of multiple organ failure syndrome and infection of pancreatic necrosis. The main etiologies are biliary lithiasis (45%) and alcohol intoxication (35%). The pathophysiological mechanisms leading to PANH remain unclear. We analyzed 102 cases of PANH admitted to the surgical intensive care unit of the Ibn Rochd University Hospital in Casablanca. The aim of this study was to descriptively analyze the epidemiological, clinical, radiological, therapeutic, and outcome data of these cases. Severity was defined by a Ranson score >3, an APACHE II score >8, the presence of organ failure, and extensive necrosis. The mean age was 52 years, with a female predominance. Biliary etiology was the most frequent (81%). Pain and vomiting were present in 95% and 77% of cases, respectively. Abdominal ultrasound revealed gallstones in 60% of patients, and CT scan showed multiple necrotic collections in 49% of cases. Treatment was mainly supportive, and the mortality rate was 38%. Several prognostic factors were identified: female sex, hemodynamic and/or respiratory failure, high severity scores, infection, and prolonged hospitalization.