Acute Pancreatitis Classification
Contents
- 1 Atlanta classification
- 2 Atlanta classification broadly classifies acute pancreatitis into two categories.
- 3 Necrotizing pancreatitis (NP) which is further subdivided into:
- 4 Based on the severity of the disease, acute pancreatitis is divided into the following types;
- 5 Two clinical phases of pancreatitis:
- 6 New terminology for fluid collections associated with acute pancreatitis is introduced :
Atlanta classification
Atlanta classification broadly classifies acute pancreatitis into two categories.
These are:
- Interstitial edematous acute pancreatitis is characterized by the acute inflammation of the pancreatic parenchyma and surrounding peri-pancreatic tissue.
- Necrotizing acute pancreatitis is characterized by necrosis of pancreatic parenchyma and peri-pancreatic tissue.
Necrotizing pancreatitis (NP) which is further subdivided into:
- parenchymal necrosis
- peripancreatic necrosis
- combined type (peripancreatic and parenchymal necrosis): most common
Based on the severity of the disease, acute pancreatitis is divided into the following types;
- In mild acute pancreatitis, there is the absence of local or systemic complications and organ failure.
- In moderately severe acute pancreatitis are local complications with or without organic failure for less than 48 hours.
- In severe acute pancreatitis, there is persistent organ failure for more than 48 hours with the involvement of one or more than one organ.
Two clinical phases of pancreatitis:
Early (1st week): in which severity is based on the presence or absence of systemic organ failure
Late (>1st week): in which severity is based on the presence of local complication or persistent systemic organ failure
New terminology for fluid collections associated with acute pancreatitis is introduced :
- Fluid collections associated with interstitial edematous pancreatitis (i.e. minimal or no necrosis)
- acute peripancreatic fluid collections (APFC): in the first 4 weeks: non-encapsulated peripancreatic fluid collections
- pseudocysts: develop after 4 weeks; encapsulated peripancreatic or remote fluid collections
- Fluid collections associated with necrotizing pancreatitis
- acute necrotic collections (ANCs): in the first 4 weeks; non-encapsulated heterogeneous non-liquefied material
- walled-off (pancreatic) necrosis (WON or WOPN): develop after 4 weeks; encapsulated heterogeneous non-liquefied material