Acute pancreatitis may be clinically mild or severe. Severe acute pancreatitis is usually a result of pancreatic glandular necrosis. The morbidity and mortality associated with acute pancreatitis are substantially higher when necrosis is present, especially when the area of necrosis is also infected.1 It is important to identify patients with pancreatic necrosis so that appropriate management can be undertaken. In recent years, the treatment of these patients has shifted away from early surgical debridement (“necrosectomy”) to aggressive intensive medical care, with specific criteria for operative and nonoperative intervention.2,3 Advances in radiologic imaging and aggressive medical management with emphasis on . . .