Revised Atlanta Classification of Acute Pancreatitis
- 1.9k Downloads
A revision of the original Atlanta Classification from 1992 was long awaited. With better understanding of the natural history and availability of better imaging tools, several limitations of this classification have been noted in different studies. In order to address these limitations and to propose a uniform classification based on modern concepts of acute pancreatitis (AP), an international working group initiated the process of a web-based reiterative consensus process in 2007. The consensus was published as the Revision of the Atlanta Classification of AP in 2013. According to the revised classification, AP has an early and a late phase with distinct clinical courses. Clear definitions of local and systemic complications have been proposed, and new terminologies for collections (acute peripancreatic fluid collections, pancreatic pseudocyst, acute necrotic collection, and walled-off necrosis) have been introduced. The severity of AP has been classified into three distinct categories, namely mild AP, moderately severe AP, and severe AP. This classification of severity is based on the presence or absence of local complications and organ failure and has been shown to have different clinical outcomes. Organ failure has been divided into transient (<48 h) and persistent (>48 h) and the presence of only persistent organ failure qualifies the disease to be labeled as severe AP.
KeywordsAcute Pancreatitis Systemic Inflammatory Response Syndrome Acute Pancreatitis Severe Acute Pancreatitis Local Complication
- 7.Muckart DJ, Bhagwanjee S. American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference definitions of the systemic inflammatory response syndrome and allied disorders in relation to critically injured patients. Crit Care Med. 1997;25:1789–95.PubMedCrossRefGoogle Scholar
- 12.Vege SS, Gardner TB, Chari ST, Munukuti P, Pearson RK, Clain JE, et al. Low mortality and high morbidity in severe acute pancreatitis without organ failure: a case for revising the Atlanta classification to include “moderately severe acute pancreatitis”. Am J Gastroenterol. 2009;104:710–5.PubMedCrossRefGoogle Scholar
- 22.Vincent JL, Moreno R, Takala J, Willatts S, De Mendonça A, Bruining H, et al. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the working group on sepsis-related problems of the European Society of Intensive Care Medicine. Intensive Care Med. 1996;22:707–10.PubMedCrossRefGoogle Scholar