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CT Severity Index (Balthazar Score) in Acute Pancreatitis

Purpose: To use the CT severity index to assess the severity of acute pancreatitis.

Description

On computed tomographic (CT) scanning of the abdomen can be used to determine the severity of acute pancreatitis and to determine a patient's prognosis. Contrast enhanced CT scans can be used to assess pancreatic necrosis, since loss of perfusion consequent to necrosis results in reduce enhancement. 


Element

Finding

Points

grade of acute pancreatitis

normal pancreas

0

 

pancreatic enlargement

1

 

inflammation involving pancreas and peripancreatic fat

2

 

single fluid collection or phlegmon

3

 

two or more fluid collections or phlegmons

4

degree of pancreatic necrosis

no necrosis

0

 

necrosis of one third of pancreas

2

 

necrosis of one half of the pancreas

4

 

necrosis of more than one half of the pancreas

6

 

CT severity index =

= (points for grade of acute pancreatitis) + (points for degree of pancreatic necrosis)

 

Interpretation:

• minimum score 0

• maximum score 10

 

Severity Index

Mortality

Complications

0-1

0%

0%

2-3

3%

8%

4-6

6%

35%

7-10

17%

92%

 


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Specialty

Objective

ICD-10