Revised Atlanta Classification of Acute Pancreatitis . The CT severity index (CTSI) combines the Balthazar grade ( points) with the. CUADRO CRITERIOS DE SEVERIDAD DE BALTHAZAR-RANSON PARA TC A.- Páncreas normal. Balthazar grado C. Indice de severidad: alto (8 puntos). Pancreatitis (descargar para ver completa). An international working group has modified the Atlanta classification for acute pancreatitis to update the terminology and provide simple.

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The possible explanation for this is the large number of patients having mild pancreatitis in their study group. This also correlated with the study by Irshad Ahmad Banday et al. Scores obtained with the modified Mortele index, show a stronger statistical correlation for all clinical outcome parameters in all the patients better than the Balthazar index.

This indicates that during surgery the differentiation between pancreatic necrosis and necrosis of the peripancreatic tissues is sometimes impossible. Todos os exames foram avaliados analisando-se inicialmente as imagens pahcreatitis fase sem contraste venoso e, posteriormente, as imagens das fases sem e com contraste venoso, conjuntamente. Of this 65 patients, 28 fulfilled the criteria of inclusion, the rest of the patients were excluded because either they had slight pancreatitis, didn’t count with tomographic evaluation or were monitored on external consult.

Central tendency measurements and dispersion for the quantitative variables were used; the frequencies are expressed in proportion terms and written between parentheses. Modified computed tomography severity index for evaluation of acute pancreatitis and its correlation with clinical outcome: Aetiology of acute pancreatitis.

The collection is balthazsr and well-demarcated with a thin wall abutting the stomach.

The presence and extent of necrosis in each case was classified into four categories and awarded points pancreatitus as follows:. These collections develop early in the course of acute pancreatitis. Balthazar E Case 4: An important consideration was the impossibility to correlate the tomographic finds with the serum concentration of reactive C proteins, which is considered until the present moment the best prognosis indicator of AP.

Morphologically there are 2 types of acute pancreatitis – interstitial or oedematous pancreatitis and necrotizing pancreatitis. Exclusion Criteria Patients with chronic pancreatitis suggested by intraductal calculi, ductal stricture and parenchymal calcification.


Aim To assess prognostic correlation and clinical outcome of acute pancreatitis on the basis of CT severity index.

Pancreas – Acute Pancreatitis 2.0

Central gland necrosis Central gland necrosis is a specific form of necrotizing pancreatitis, representing full thickness necrosis between the pancreatic head and tail and is nearly always associated with disruption of the pancreatic duct. No necrosis was noted in patients with grade B pancreatitis. Sample size was small which may have affected the result. Extensive peripancreatic collections, which have liquid and non-liquid densities on CT.

Clinical suspicion or documented infected necrotizing pancreatitis with clinical deterioration Ongoing organ failure for several weeks after disease onset in the absence of documented infected necrotizing pancreatitis.

CT Evaluation of Acute Pancreatitis and its Prognostic Correlation with CT Severity Index

Revised Atlanta classification is more accurate than modified Mortele index and Balthazar severity index for assessing patient mortality and organ failure.

Results During the research period, there was an admission of 1, patients to clasifficacion Gastroenterology Service of Mexico’s General Hospital, in which 65 4. As early treatment of patients with severe acute pancreatitis can reduce morbidity and mortality.

Rev Med Int Baothazar Crit ; 1: The study group consisted of 35 male and 15 female patients with a male: They are not or only partially encapsulated. Acute peripancreatic collection Acute necrotic collection Pseudocyst Walled off necrosis 36 24 0 0. Imaging and intervention in acute pancreatitis. The strong relationship between the Modified CT severity index and the patient outcome in this study corroborates with the findings of Mortele et al.

Balthazar score | Radiology Reference Article |

A T2-weighted MRI sequence shows that the collection has a low signal intensity arrow. Cytokine cascades result in a systemic inflammatory response syndrome SIRSwhich increases the risk of organ failure.

They may remain sterile or develop infection. Identification of pancreas necrosis in severe acute pancreatitis: Mild – No organ failure and no local or systemic complications. These collections are the result of the release of activated pancreatic enzymes which also cause necrosis of the surrounding tissues. We found a similar distribution between the slight and severe disease: These collections also show homogeneous high signal intensity on a fat-suppressed T2-weighted MRI image, are fully encapsulated and contain clear fluid i.


Communication with the pancreatic duct may be present. Early assessment of the cause and severity of acute pancreatitis is of utmost importance for prompt treatment and close monitoring of patient with severe disease.

According to the Balthazar tomographic degree and the AP severity of clinical and biochemical criteria, of the patients that were classified within slight disease, none was classified within the A Balthazar degree, Temporallytwo phases of acute pancreatitis are identified in the Revised Atlanta Classification:.

Concerning the hematocrit value, 57 and Balthazar D or E, without pancreatic necrosis; peripancreatic collections are due to extrapancreatic necrosis severe pancreatitis necrotising: Less commonly only the peripancreatic tissues. The AP diagnosis was performed to the patients that had at least 2 of the 3 following criteria: It can be suggested that there does not exist a statistically meaningful correlation between the APACHE-II scale of seriousness and the advanced Balthazar degrees due to the report of a poor correlation between Pearson and Spearman’s, therefore it is likely to find very ill patients with an A or B Balthazar and on the other hand patients with slight acute pancreatitis with D o E Balthazar.

The s everity is classified into three categories based on clinical and morphologic findings according to revised Atlanta classification [ 8 ].

The characteristics of the patients that were included on the study are shown on table I. Usually occurs in the 2nd-4th week and rarely in the first week. This fluid collection is encapsulated.

CT Evaluation of Acute Pancreatitis and its Prognostic Correlation with CT Severity Index

The severity of pancreatitis was scored using CT severity index, modified severity index and revised Atlanta balthazwr and classified into mild, moderate, severe categories. This patient had fever and multiple organ failure. Staging of acute pancreatitis.