Acute pancreatitis classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]

Overview

Acute pancreatitis may be classified according to the severity of disease into 2 subtypes: mild (interstitial or edematous) and severe (necrotising or organ failure).

Classification

Atlanta criteria (1993)	Atlanta Revision (2013)
Mild acute pancreatitis	Mild acute pancreatitis
Absence of organ failure	Absence of organ failure
Absence of local complications	Absence of local complications
Severe acute pancreatitis	Moderately severe acute pancreatitis
1. Local complications AND/OR	1. Local complications AND/OR
2. Organ failure	2. Transient organ failure (< 48 h)
GI bleeding (> 500 cc/24 hr)	Severe acute pancreatitis
Shock – SBP ≤ 90 mm Hg	Persistent organ failure > 48 h
PaO 2 ≤ 60%
Creatinine ≥ 2 mg/dl

The revised Atlanta classification for acute pancreatitis classifies it as:

• Mild pancreatitis (interstitial or edematous): inflammation of parenchyma of pancreas without local or systemic complications.
• Severe pancreatitis (necrotising or organ failure): severe pancreatitis causing local and systemic manifestations.

Acute pancreatitis is further distinguished clinically into early phase (1st week) and late phase (after the 1st week).