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:[1][2][3][4][5][6][7][8]
- Mild pancreatitis (interstitial or edematous): inflammation of parenchyma of pancreas without local or systemic complications.
- Severe pancreatitis (necrotizing or organ failure): severe pancreatitis causing local and systemic manifestations.[9]
Acute pancreatitis is further distinguished clinically into
- Early phase (1st week).
- Late phase (after the 1st week).
References
- ↑ Bradley EL (1993). "A clinically based classification system for acute pancreatitis. Summary of the International Symposium on Acute Pancreatitis, Atlanta, Ga, September 11 through 13, 1992". Arch Surg. 128 (5): 586–90. PMID 8489394.
- ↑ Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG, Tsiotos GG, Vege SS (2013). "Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus". Gut. 62 (1): 102–11. doi:10.1136/gutjnl-2012-302779. PMID 23100216.
- ↑ Busquets J, Fabregat J, Pelaez N, Millan M, Secanella L, Garcia-Borobia F, Masuet C, García LM, Martinez-Garcia L, Lopez-Borao J, Valls C, Santafosta E, Estremiana F (2013). "Factors influencing mortality in patients undergoing surgery for acute pancreatitis: importance of peripancreatic tissue and fluid infection". Pancreas. 42 (2): 285–92. doi:10.1097/MPA.0b013e318264664d. PMID 23357922.
- ↑ Marshall JC, Cook DJ, Christou NV, Bernard GR, Sprung CL, Sibbald WJ (1995). "Multiple organ dysfunction score: a reliable descriptor of a complex clinical outcome". Crit. Care Med. 23 (10): 1638–52. PMID 7587228.
- ↑ Tenner S (2004). "Initial management of acute pancreatitis: critical issues during the first 72 hours". Am. J. Gastroenterol. 99 (12): 2489–94. doi:10.1111/j.1572-0241.2004.40329.x. PMID 15571599.
- ↑ Banks PA, Freeman ML (2006). "Practice guidelines in acute pancreatitis". Am. J. Gastroenterol. 101 (10): 2379–400. doi:10.1111/j.1572-0241.2006.00856.x. PMID 17032204.
- ↑ Perez A, Whang EE, Brooks DC, Moore FD, Hughes MD, Sica GT, Zinner MJ, Ashley SW, Banks PA (2002). "Is severity of necrotizing pancreatitis increased in extended necrosis and infected necrosis?". Pancreas. 25 (3): 229–33. PMID 12370532.
- ↑ Bakker OJ, van Santvoort H, Besselink MG, Boermeester MA, van Eijck C, Dejong K, van Goor H, Hofker S, Ahmed Ali U, Gooszen HG, Bollen TL (2013). "Extrapancreatic necrosis without pancreatic parenchymal necrosis: a separate entity in necrotising pancreatitis?". Gut. 62 (10): 1475–80. doi:10.1136/gutjnl-2012-302870. PMID 22773550.
- ↑ Thoeni RF (2012). "The revised Atlanta classification of acute pancreatitis: its importance for the radiologist and its effect on treatment". Radiology. 262 (3): 751–64. doi:10.1148/radiol.11110947. PMID 22357880. Unknown parameter
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