GI ToolsGastroenterology and hepatology

Revised Atlanta classification

The revised Atlanta classification (2012) defines the severity of acute pancreatitis by organ failure and complications, and names collections by their age and whether they contain necrosis.

Organ failure (modified Marshall score 2 or more in any system)

Respiratory: PaO₂/FiO₂ 300 or less. Renal: creatinine 170 µmol/L or more. Cardiovascular: systolic pressure below 90 mmHg not responding to fluid.

Local or systemic complications

Local: collections, gastric outlet dysfunction, splanchnic vein thrombosis, colonic necrosis. Systemic: exacerbation of a pre-existing condition such as heart or lung disease.

Collection (optional): time since onset of pancreatitis
Collection (optional): contents

Enter the values above.

Modified Marshall scoring system

System01234
Respiratory (PaO₂/FiO₂)Above 400301 to 400201 to 300101 to 200101 or less
Renal (creatinine, µmol/L)Below 134134 to 169170 to 310311 to 439Above 439
Cardiovascular (systolic pressure, mmHg)Above 90Below 90, fluid responsiveBelow 90, not fluid responsiveBelow 90, pH below 7.3Below 90, pH below 7.2

Reference

Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis—2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102-111.