This page includes the following topics and synonyms: Revised Atlanta Criteria for Acute Pancreatitis Severity. There have been important changes in the definitions and classification of AP since the Atlanta classification from (5). During the past decade, several. The Revised Atlanta Classification discerns 4 in acute pancreatitis depending on the content.

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However the presence or absence of IN does not count in classifying patients as moderate or severe AP. When should we be concerned about pancreatic necrosis?

The Radiology Assistant : Pancreas – Acute Pancreatitis

The frequency of fatal hemorrhagic complications of pancreatitis varies between 1. Moreover the emerging data on extrapancreatic necrosis needs to be considered in severity stratification. Abdom Imaging ; Doberneck [ 51 ] reported development of intestinal fistulae in about half of their patients with necrotizing pancreatitis, again more often after an intervention.

The necrotic debris was too viscous for successful percutaneous drainage. The category of moderately severe pancreatitis is rather not well defined.

Pancreas – Acute Pancreatitis 2.0

Walled-off-necrosis 2 These CT-images pancrfatitis of a patient on day Diagnosis with spiral CT using rectal water soluble contrast media. World J Gastroenterol ; Classification of the Severity of Acute Pancreatitis.


When peripancreatic collections persist or increase, it is usually due to the presence of fat necrosis. All types of necrotising pancreatitis may be sterile or infected; gas formation is the best imaging feature to suggest infection. Take home messages Be familiar with the terminology in acute pancreatitis using the Revised Atlanta Classification. Visit for more related articles at JOP.

Classification of acute pancreatitis Once the clinical condition of the patient deteriorates and the patient is febrile, fine needle aspiration FNA can be used to differentiate between sterile and infected collections.

Vascular complications like arterial and venous thrombosis and pseudo-aneurysms can also adversely affect the outcome of AP. Colonic fistula associated with severe acute pancreatitis: Does it Make a Difference? This patient had an acute necrotizing pancreatitis with onset 2 months earlier. On a follow-up scan the collection in the right anterior pararenal space increased in size.

Revised Atlanta Criteria for Acute Pancreatitis Severity

So this is an ANC – acute necrotic collection. Frequently they regress spontaneously.

As the patient’s condition worsened, a second CT was performed on day 3. Continue with the next image. The revisions of OAC and definitions have been updated recently as the revised Atlanta classification RAC [ 4 ] according to which the diagnosis of AP requires two of the following three features: However, these definitions of severity and local complications received considerable criticism over the subsequent two decades [ 2 ].


Ongoing gastric outlet, intestinal, or biliary obstruction due to mass effect of walled-off necrosis i. They are seen within 4 weeks in necrotizing pancreatitis.

The terms pancreatic abscess and intrapancreatic pseudocyst are totally abandoned in this new classification. As pointed out in the preceding text the category of MSAP needs to be better defined.

Can’t read the image? The revised Atlanta classification of acute pancrdatitis The CT severity index CTSI combines the Balthazar grade points with the extent of pancreatic necrosis points on a point severity scale.

Incidence of individual organ dysfunction in fatal acute pancreatitis: Morphologically there are 2 types of acute pancreatitis – interstitial or oedematous pancreatitis and necrotizing pancreatitis.