| | | | | | The Medical Algorithms Project |
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| Chapter : | ch11. Hepatobiliary & Pancreas | Section : | Diagnosis and Prognosis of Pancreatitis | | CT Severity Index (Balthazar Score) in Acute Pancreatitis | | Copyright (c) 2006-2007, Institute for Algorithmic Medicine, Houston, TX, USA. All rights reserved. |
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Overview :
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% |
| | References: | |
Balthazar
EJ, Robinson DL, et al. Acute pancreatitis: Value of CT in establishing
prognosis. Radiology. 1990; 174: 331-336.
Marshall
JB. Acute pancreatitis. Arch Intern Med. 1993; 153: 1185-1198.
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