In 1992, the International Symposium on Acute Pancreatitis established criteria for severe pancreatitis. It is characterized by the presence of local complications affecting the pancreas, such as necrosis, abscess, or pseudocyst, or any signs of organ failure. A diagnosis of severe pancreatitis is confirmed when either organ failure or local pancreatic complications are identified.
| Category | Criteria |
|---|---|
| Organ Failure | – Shock (systolic blood pressure <90 mm Hg) |
| – Pulmonary insufficiency (PaO₂ <60 mm Hg) | |
| – Renal failure (creatinine level >2 mg/dL after fluid resuscitation) | |
| – Gastrointestinal bleeding (>500 mL/24 hour) | |
Systemic Complications | – Disseminated intravascular coagulation (platelet count ≤100,000) |
| – Fibrinogen <1 g/L | |
| – Fibrin split products >80 μg/dL | |
| – Metabolic disturbance (calcium level ≤7.5 mg/dL) | |
Local Complications | – Necrosis |
| – Abscess | |
| – Pseudocyst | |
Severe Pancreatitis | Defined by the presence of any evidence of organ failure or a local complication. |
