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Pancreatic Collections Nomenclature & Modified CT Severity Index

Revised Atlanta (2012) + Modified CTSI (Mortele 2004)

Names pancreatic and peripancreatic collections correctly per the Revised Atlanta Classification and scores radiologic severity of acute pancreatitis with the Modified CT Severity Index (Mortele).

Also searched as: pancreas · pancreatitis · atlanta · ctsi · pseudocyst · necrosis · walled off necrosis

Time since onset of pain

Collections part: timing separates acute from delayed collections.

Collection morphology

Collections part: wall and internal content determine the name.

Pancreatic appearance on CT

MCTSI part: scores 0, 2, or 4 respectively.

CT evidence of pancreatic necrosis

MCTSI part: scores 0, 2, or 4 respectively.

Extrapancreatic complications present

Pleural effusion, ascites, vascular complications, parenchymal organ, or gastrointestinal involvement (scores 2).

Information
Incomplete input
  • Missing required input: time since onset of pain; collection morphology; pancreatic appearance; extent of pancreatic necrosis; extrapancreatic complications (yes/no).

How this tool works

Collection nomenclature depends on time from symptom onset and internal structure. Within the first 4 weeks, a homogeneous fluid collection without a definable wall is an acute peripancreatic fluid collection (interstitial edematous pancreatitis), whereas a collection containing non-liquefied debris without a wall is an acute necrotic collection (necrotizing pancreatitis). After about 4 weeks, an encapsulated homogeneous fluid collection is a pseudocyst, and an encapsulated collection with non-liquefied components is walled-off necrosis. The Modified CT Severity Index sums points for pancreatic appearance (0/2/4), pancreatic necrosis (0/2/4), and extrapancreatic complications (0/2); totals of 0-2, 4-6, and 8-10 correspond to mild, moderate, and severe radiologic grades, which correlate with morbidity and mortality.

Clinical questions that use this

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