Bradley reported the criteria for severe acute pancreatitis developed at the International Symposium on Acute Pancreatitis held in Atlanta, Georgia.


Criteria for severe acute pancreatitis - one or more of the following:

(1) Ranson score on admission >= 3 (or during the first 48 hours)

(2) APACHE II score >= 8 at any time during course

(3) presence of one or more organ failures

(4) presence of one or more local complications


Organ failures include:

(1) shock (systolic blood pressure less than 90 mm Hg)

(2) pulmonary insufficiency (PaO2 <= 60 mm Hg on room air)

(3) renal failure (serum creatinine > 2 mg/dL after fluid replacement)

(4) gastrointestinal bleeding, with > 500 mL estimated loss within 24 hours

(5) DIC (thrombocytopenia and hypofibrinogenemia and fibrin split products)

(6) severe hypocalemia (<= 7.5 mg/dL)


Local complications include:

(1) pancreatic necrosis

(2) pancreatic abscess

(3) pancreatic pseudocyst


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