Approach to management of walled-off necrosis secondary to trauma-induced pancreatitis in a limited-resource setting.

Authors

Sreelakshmi Pradeep, Daniston Ratnaraj, Dawn Kuruvilla, Siddharth M Babu, Sujith Philip, Philip Finny

Published in

BMJ case reports. Volume 19. Issue 10. Oct 06, 2026. Epub Oct 06, 2026.

Abstract

Walled-off necrosis (WON) is a well-defined collection of necrotic tissue that arises as a long-standing complication of acute pancreatitis, developing more than four weeks after the initial episode. It contains liquid and solid necrotic material within a mature fibrous wall lacking an epithelial lining. This encapsulation forms through an inflammatory response that walls off necrotic tissue, creating a discrete entity that is distinguishable on imaging. WON is more prone to infection and requires prompt intervention.In this case, a patient who had trauma-induced pancreatitis developed a necrotic peripancreatic collection which formed a WON. Imaging showed a mature collection with necrotic debris. Due to persistent symptoms and nutritional decline, the patient underwent open cystogastrostomy for internal drainage and Stamm feeding jejunostomy for enteral nutrition. This surgical approach provided symptomatic relief, improved nutrition and reduced infection risk. Timely surgical intervention is vital in managing symptomatic or complicated cases, especially when less invasive methods are not feasible.

PMID:
42838710
Bibliographic data and abstract were imported from PubMed on 07 Oct 2026.

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