What about necrotizing pancreatitis? Acute pancreatitis can be divided into acute edematous pancreatitis and acute necrotizing pancreatitis from pathological classification. Acute edematous pancreatitis mainly manifests as interstitial edema and inflammatory reaction, while acute necrotizing pancreatitis is pancreatic parenchymal necrosis and hemorrhage. In essence, acute necrotizing pancreatitis is mostly developed from acute edematous pancreatitis. In acute necrotizing pancreatitis, the pancreatic gland becomes enlarged and hypertrophic, and the appearance may appear dark purple. The pancreatic necrotic foci are mostly scattered or patchily distributed around the pancreas, and total pancreatic tissue necrosis rarely occurs. The necrotic lesions vary in size and are grayish-black in color, and may be black in the later stages when accompanied by pancreatic tissue gangrene. The patient’s abdominal cavity is accompanied by a bloody exudate, and the exudate contains a large amount of amylase. Therefore, laparotomy in patients with acute necrotizing pancreatitis to detect the amylase content of the peritoneal fluid is very helpful to confirm the diagnosis of acute necrotizing pancreatitis. Acute necrotizing pancreatitis can be seen microscopically as fat necrosis and severe destruction of alveoli, digestion of blood vessels with massive bleeding, destruction of pancreatic alveoli and lobules, dilatation of pancreatic ducts, and may be accompanied by arterial thrombosis. Acute necrotizing pancreatitis tends to develop rapidly and has a poor prognosis. Patients with necrotic tissue accompanied by infection can cause chills, high fever, and abdominal pain. Some patients even have cyanotic skin changes around the waist or rib abdomen and navel, which is often caused by the spillage of pancreatic fluid into the subcutaneous tissue space and destruction of fat and blood vessels. This is the clinical manifestation of the aggravation of the disease.