Phillip V, Steiner JM, Algül H. Early phase of acute pancreatitis: Assessment and management. World J Gastrointest Pathophysiol 2014; 5(3): 158-168 [PMID: 25133018 DOI: 10.4291/wjgp.v5.i3.158]
Corresponding Author of This Article
Hana Algül, MD, MPH, II. Medizinische Klinik und Poliklinik, Klinikum rechts der Isar der Technische Universität München, Ismaninger Straße 22, 81675 München, Germany. hana.alguel@lrz.tum.de
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Topic Highlight
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World J Gastrointest Pathophysiol. Aug 15, 2014; 5(3): 158-168 Published online Aug 15, 2014. doi: 10.4291/wjgp.v5.i3.158
Table 1 Prognostic criteria of Ranson
On admission
After 48 h
Age > 55 yr
Hematocrit fall > 10%
White blood cell count > 16000/mL
BUN increase > 1.8 mmol/L
Blood glucose concentration > 11.1 mmol/L
Serum calcium < 2 mmol/L
LDH > 350 IU/L
PaO2 < 60 mmHg
ASAT > 250 IU/L
Base deficit > 4 mmol/L
Fluid sequestration > 6 L
Table 2 Bedside index of severity in acute pancreatitis score and observed mortality by bedside index of severity in acute pancreatitis score score
BUN > 8.9 mmol/L
Impaired mental status (Glasgow coma scale < 15)
SIRS, defined by the presence of two or more
Temperature
< 36 °C or > 38 °C (< 96.8 °F or > 100.4 °F)
Heart rate
> 90 per minute
Respiratory rate
> 20 per minute or PaCO2 < 32 mmHg
White blood cell count
< 4000/mL or > 12000/mL or > 10% immature neutrophils
Age > 60 yr
Pleural effusion
BISAP score
Mortality (%)
0
0.1-0.2
1
0.5-0.7
2
1.9-2.1
3
5.3-8.3
4
12.7-19.3
5
22.5-26.7
Table 3 Balthazar score
Grade A
Normal pancreas
Grade B
Focal or diffuse enlargement of the pancreas
Grade C
Pancreatic changes associated with peripancreatic inflammation
Grade D
Single fluid collection
Grade E
Two or more fluid collections and/or presence of gas within the pancreas or within peripancreatic inflammation
Table 4 Computed tomography severity index
Extent of necrosis
Points
Absence of necrosis
0
< 30% necrosis
2
30%-50% necrosis
4
> 50% necrosis
6
Balthazar score
A
0
B
1
C
2
D
3
E
4
Citation: Phillip V, Steiner JM, Algül H. Early phase of acute pancreatitis: Assessment and management. World J Gastrointest Pathophysiol 2014; 5(3): 158-168