CT Severity Index in Pancreatitis

Aka: CT Severity Index in Pancreatitis, Balthazar Computed Tomography Severity Index

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II. Criteria: CT Score

  1. Score 0: Normal Pancreas (Grade A)
  2. Score 1: Edematous Pancreas (Grade B)
  3. Score 2: Edematous Pancreas and mild extrapancreatic changes (Grade C)
  4. Score 3: Severe extrapancreatic changes AND one fluid collection (Grade D)
  5. Score 4: Multiple or extensive fluid collections (Grade E)

III. Criteria: Necrosis Score

  1. Score 0: No necrosis
  2. Score 2: Necrosis <33%
  3. Score 4: Necrosis 33% to 50%
  4. Score 6: Necrosis 50% or more

IV. Interpretation

  1. Based on total = CT Score + Necrosis Score
  2. CT Severity Index Score 5 or greater (compared with score <5)
    1. Longer length of hospitalization
    2. Mortality increased 15 fold

V. References

  1. Balthazar (1990) Radiology 174(2): 331-6 [PubMed]
  2. Balthazar (1994) Radiology 193(2): 297-306 [PubMed]
  3. Leung (2005) World J Gastroenterol 11(38): 6049-52 [PubMed]

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