| | | | | | The Medical Algorithms Project |
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| Chapter : | ch11. Hepatobiliary & Pancreas | Section : | Diagnosis and Prognosis of Pancreatitis | | Clinical Criteria in Acute Pancreatitis of Bank et al. | | Copyright (c) 2006-2007, Institute for Algorithmic Medicine, Houston, TX, USA. All rights reserved. |
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Overview :
Bank et al listed clinical criteria associated with poor
prognosis in patients with acute pancreatitis. This can help identify those
patients who may require more intensive care.
|
Organ
System |
Finding |
|
cardiac |
severe hypotension or shock |
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tachycardia > 130 beats per minute |
|
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arrhythmia |
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ECG changes |
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pulmonary |
dyspnea |
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rales, pulmonary edema |
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PaO2 < 60 mm Hg |
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adult respiratory distress syndrome |
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renal |
urine output < 50 mL/h |
|
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increasing BUN and/or creatinine |
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metabolic |
low or falling calcium |
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low or falling pH |
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decreased albumin |
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hematologic |
falling hematocrit |
|
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DIC (low platelet counts, fibrin split
products) |
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neurological |
irritability |
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confusion |
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localizing signs on neurological examination |
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hemorrhagic pancreatitis |
Grey-Turner or Cullen signs; evidence on peritoneal
tap |
|
tense distension (abdomen) |
severe ileus, fluid 2+ |
number of Bank's criteria =
= SUM(findings present)
Interpretation:
• minimum
number = 0
• maximum
number = 20
• Severe
disease (potentially lethal) may occur if 1 or more of these findings is
present.
| | References: | |
Agarwal N,
Pitchumoni CS. Simplified prognostic criteria in acute pancreatitis. Pancreas.
1986; 1: 69-73.
Bank S,
Wise L. Risk factors in acute pancreatitis. Am J Gastroenterol. 1982; 77: 680
(Abstract 7).
Bank S,
Wise L, et al. Risk factors in acute pancreatitis. Am J Gastroenterol. 1983; 78:
637-640.
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