{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T16:52:40Z","timestamp":1791305560291,"version":"4.3.1"},"reference-count":17,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,9,15]]},"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:p>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.<\/jats:p>\n                  <jats:p>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.<\/jats:p>","DOI":"10.1136\/bcr-2026-272557","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T16:05:17Z","timestamp":1791302717000},"page":"e272557","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Approach to management of walled-off necrosis secondary to trauma-induced pancreatitis in a limited-resource setting"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3413-3906","authenticated-orcid":false,"given":"Sreelakshmi","family":"Pradeep","sequence":"first","affiliation":[{"name":"Believers Church Medical College Hospital, Thiruvalla, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniston","family":"Ratnaraj","sequence":"additional","affiliation":[{"name":"Jiwan Jyoti Christian Hospital, Robertsganj, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawn","family":"Kuruvilla","sequence":"additional","affiliation":[{"name":"Jiwan Jyoti Christian Hospital, Robertsganj, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6047-427X","authenticated-orcid":false,"given":"Siddharth M","family":"Babu","sequence":"additional","affiliation":[{"name":"Department of Hepato Pancreato Biliary Surgery, Christian Medical College Vellore, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sujith","family":"Philip","sequence":"additional","affiliation":[{"name":"Surgical Gastroenterology, Believers Church Medical College Hospital, Thiruvalla, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1403-8934","authenticated-orcid":false,"given":"Philip","family":"Finny","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Believers Church Medical College Hospital, Thiruvalla, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"2026100609050946000_19.10.e272557.1","doi-asserted-by":"crossref","first-page":"1994","DOI":"10.1053\/j.gastro.2019.01.269","article-title":"Current Concepts in Severe Acute and Necrotizing Pancreatitis: An Evidence-Based Approach","volume":"156","author":"Trikudanathan","year":"2019","journal-title":"Gastroenterology"},{"key":"2026100609050946000_19.10.e272557.2","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1007\/s00423-020-01944-6","article-title":"Severe acute pancreatitis: surgical indications and treatment","volume":"406","author":"Heckler","year":"2021","journal-title":"Langenbecks Arch Surg"},{"key":"2026100609050946000_19.10.e272557.3","doi-asserted-by":"crossref","first-page":"2747","DOI":"10.3748\/wjg.v29.i18.2747","article-title":"Current trends in acute pancreatitis: Diagnostic and therapeutic challenges","volume":"29","author":"Zerem","year":"2023","journal-title":"World J Gastroenterol"},{"key":"2026100609050946000_19.10.e272557.4","doi-asserted-by":"crossref","first-page":"203","DOI":"10.25122\/jml-2018-0045","article-title":"Hepatic hydatid cyst - 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