{"id":2539,"date":"2009-03-03T18:33:05","date_gmt":"2009-03-03T18:33:05","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/gasranson\/"},"modified":"2025-05-14T19:11:00","modified_gmt":"2025-05-14T19:11:00","slug":"gasranson","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/gasranson\/","title":{"rendered":"Severity Criteria for Acute Pancreatitis"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p><\/p>\n<div class=\"Section1\">\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><strong>Ranson Criteria to Predict Severity of Acute Pancreatitis<\/strong><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">1. When three or more of the following are present on admission, a severe course complicated by pancreatic necrosis can be predicted with a sensitivity of 60-80%:<\/p>\n<p><!--more--><\/p>\n<ul>\n<li>Age over 55 years.<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">White blood cell count over 16,000\/uL.<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Blood glucose over 200 mg\/dL.<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Serum lactate dehydrogenase (LDH) over 350 units\/L.<\/p>\n<\/li>\n<li>Aspartate aminotransferase (AST, SGOT) over 250 units\/L.\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">\n<\/li>\n<\/ul>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">2. Development of the following in the first 48 hours indicates a worsening prognosis:<\/p>\n<ul>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Hematocrit drop of more than ten percentage points.<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><strong> <span style=\"font-weight: normal;\"> Blood urea nitrogen<\/span><\/strong> (BUN) rise greater than 5 mg\/dL.<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Arterial PO2 of less than 60 mm Hg.<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Serum calcium of less than 8 mg\/dL.<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Base deficit over 4 meq\/L.<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Estimated fluid sequestration of more than 6 L.<\/p>\n<\/li>\n<\/ul>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">3. Mortality rates correlate with the number of criteria present:<\/p>\n<div>\n<table style=\"border-collapse: collapse; width: 100%;\" border=\"1\">\n<tbody>\n<tr>\n<td style=\"border: 1pt solid windowtext; padding: 0cm 5.4pt;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Number of criteria<\/p>\n<\/td>\n<td style=\"border-style: solid solid solid none; border-color: windowtext windowtext windowtext -moz-use-text-color; border-width: 1pt 1pt 1pt medium; padding: 0cm 5.4pt;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\" style=\"text-align: center; margin-top: 0pt; margin-bottom: 0pt;\" align=\"center\">Mortality rate<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td style=\"border-style: none solid solid; border-color: -moz-use-text-color windowtext windowtext; border-width: medium 1pt 1pt; padding: 0cm 5.4pt;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">0-2<\/p>\n<\/td>\n<td style=\"border-style: none solid solid none; border-color: -moz-use-text-color windowtext windowtext -moz-use-text-color; border-width: medium 1pt 1pt medium; padding: 0cm 5.4pt;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\" style=\"text-align: center; margin-top: 0pt; margin-bottom: 0pt;\" align=\"center\">1%<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td style=\"border-style: none solid solid; border-color: -moz-use-text-color windowtext windowtext; border-width: medium 1pt 1pt; padding: 0cm 5.4pt;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">3-4<\/p>\n<\/td>\n<td style=\"border-style: none solid solid none; border-color: -moz-use-text-color windowtext windowtext -moz-use-text-color; border-width: medium 1pt 1pt medium; padding: 0cm 5.4pt;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\" style=\"text-align: center; margin-top: 0pt; margin-bottom: 0pt;\" align=\"center\">16%<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td style=\"border-style: none solid solid; border-color: -moz-use-text-color windowtext windowtext; border-width: medium 1pt 1pt; padding: 0cm 5.4pt;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">5-6<\/p>\n<\/td>\n<td style=\"border-style: none solid solid none; border-color: -moz-use-text-color windowtext windowtext -moz-use-text-color; border-width: medium 1pt 1pt medium; padding: 0cm 5.4pt;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\" style=\"text-align: center; margin-top: 0pt; margin-bottom: 0pt;\" align=\"center\">40%<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td style=\"border-style: none solid solid; border-color: -moz-use-text-color windowtext windowtext; border-width: medium 1pt 1pt; padding: 0cm 5.4pt;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">7-8<\/p>\n<\/td>\n<td style=\"border-style: none solid solid none; border-color: -moz-use-text-color windowtext windowtext -moz-use-text-color; border-width: medium 1pt 1pt medium; padding: 0cm 5.4pt;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\" style=\"text-align: center; margin-top: 0pt; margin-bottom: 0pt;\" align=\"center\">100%<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<p>&nbsp;<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><strong>Balthazar CT severity index for acute pancreatitis<\/strong><\/p>\n<table style=\"border-collapse: collapse; width: 100%;\" border=\"1\">\n<tbody>\n<tr>\n<td style=\"border: 1pt solid windowtext; padding: 0cm 5.4pt; width: 128px;\" valign=\"top\">\n<p class=\"MsoNormal\"><strong> CT Grade<\/strong><\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 36px; border: 1pt 1pt 1pt medium solid solid solid none windowtext windowtext windowtext -moz-use-text-color;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\"><strong> Points<\/strong><\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 52px; border: 1pt 1pt 1pt medium solid solid solid none windowtext windowtext windowtext -moz-use-text-color;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><strong> Necrosis<\/strong><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><strong>(%)<\/strong><\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 58px; border: 1pt 1pt 1pt medium solid solid solid none windowtext windowtext windowtext -moz-use-text-color;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><strong> Additional<\/strong><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><strong>Points<\/strong><\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 51px; border: 1pt 1pt 1pt medium solid solid solid none windowtext windowtext windowtext -moz-use-text-color;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><strong> Severity<\/strong><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><strong>Index<\/strong><\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 54px; border: 1pt 1pt 1pt medium solid solid solid none windowtext windowtext windowtext -moz-use-text-color;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><strong> Mortality<\/strong><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><strong>Rate (%)<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td style=\"padding: 0cm 5.4pt; width: 128px; border: medium 1pt 1pt none solid solid -moz-use-text-color windowtext windowtext;\" valign=\"top\">\n<p class=\"MsoNormal\">A- Normal pancreas<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 36px; border: medium 1pt 1pt medium none solid solid none -moz-use-text-color windowtext windowtext -moz-use-text-color;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\">0<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 52px; border: medium 1pt 1pt medium none solid solid none -moz-use-text-color windowtext windowtext -moz-use-text-color;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\">0<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 58px; border: medium 1pt 1pt medium none solid solid none -moz-use-text-color windowtext windowtext -moz-use-text-color;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\">0<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 51px; border: medium 1pt 1pt medium none solid solid none -moz-use-text-color windowtext windowtext -moz-use-text-color;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\">0<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 54px; border: medium 1pt 1pt medium none solid solid none -moz-use-text-color windowtext windowtext -moz-use-text-color;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\">0<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td style=\"padding: 0cm 5.4pt; width: 128px; border: medium 1pt 1pt none solid solid -moz-use-text-color windowtext windowtext;\" valign=\"top\">\n<p class=\"MsoNormal\">B- Pancreatic enlargement<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 36px; border: medium 1pt 1pt medium none solid solid none -moz-use-text-color windowtext windowtext -moz-use-text-color;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\">1<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 52px; border: medium 1pt 1pt medium none solid solid none -moz-use-text-color windowtext windowtext -moz-use-text-color;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\">0<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 58px; border: medium 1pt 1pt medium none solid solid none -moz-use-text-color windowtext windowtext -moz-use-text-color;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\">0<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 51px; border: medium 1pt 1pt medium none solid solid none -moz-use-text-color windowtext windowtext -moz-use-text-color;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\">1<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 54px; border: medium 1pt 1pt medium none solid solid none -moz-use-text-color windowtext windowtext -moz-use-text-color;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\">0<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td style=\"padding: 0cm 5.4pt; width: 128px; border: medium 1pt 1pt none solid solid -moz-use-text-color windowtext windowtext;\" valign=\"top\">\n<p class=\"MsoNormal\">C- Pancreatic inflammation and\/or peripancreatic fat<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 36px; border: medium 1pt 1pt medium none solid solid none -moz-use-text-color windowtext windowtext -moz-use-text-color;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\">2<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 52px; border: medium 1pt 1pt medium none solid solid none -moz-use-text-color windowtext windowtext -moz-use-text-color;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\">&lt; 30<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 58px; border: medium 1pt 1pt medium none solid solid none -moz-use-text-color windowtext windowtext -moz-use-text-color;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\">2<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 51px; border: medium 1pt 1pt medium none solid solid none -moz-use-text-color windowtext windowtext -moz-use-text-color;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\">4<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 54px; border: medium 1pt 1pt medium none solid solid none -moz-use-text-color windowtext windowtext -moz-use-text-color;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\">0<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td style=\"padding: 0cm 5.4pt; width: 128px; border: medium 1pt 1pt none solid solid -moz-use-text-color windowtext windowtext;\" valign=\"top\">\n<p class=\"MsoNormal\">D- Single peripancreatic fluid collection<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 36px; border: medium 1pt 1pt medium none solid solid none -moz-use-text-color windowtext windowtext -moz-use-text-color;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\">3<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 52px; border: medium 1pt 1pt medium none solid solid none -moz-use-text-color windowtext windowtext -moz-use-text-color;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\">30-50<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 58px; border: medium 1pt 1pt medium none solid solid none -moz-use-text-color windowtext windowtext -moz-use-text-color;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\">4<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 51px; border: medium 1pt 1pt medium none solid solid none -moz-use-text-color windowtext windowtext -moz-use-text-color;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\">7<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 54px; border: medium 1pt 1pt medium none solid solid none -moz-use-text-color windowtext windowtext -moz-use-text-color;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\">&gt; 17<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td style=\"padding: 0cm 5.4pt; width: 128px; border: medium 1pt 1pt none solid solid -moz-use-text-color windowtext windowtext;\" valign=\"top\">\n<p class=\"MsoNormal\">E- Two or more fluid collections or retroperitoneal air<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 36px; border: medium 1pt 1pt medium none solid solid none -moz-use-text-color windowtext windowtext -moz-use-text-color;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\">4<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 52px; border: medium 1pt 1pt medium none solid solid none -moz-use-text-color windowtext windowtext -moz-use-text-color;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\">&gt; 50<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 58px; border: medium 1pt 1pt medium none solid solid none -moz-use-text-color windowtext windowtext -moz-use-text-color;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\">6<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 51px; border: medium 1pt 1pt medium none solid solid none -moz-use-text-color windowtext windowtext -moz-use-text-color;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\">10<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 54px; border: medium 1pt 1pt medium none solid solid none -moz-use-text-color windowtext windowtext -moz-use-text-color;\" align=\"center\" valign=\"top\"><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p class=\"MsoNormal\">CT severity index equals unenhanced CT score plus necrosis score (based upon contrast enhanced CT) : maximum = 10, &gt;\/=6 = severe disease.<\/p>\n<p>&nbsp;<\/p>\n<p class=\"MsoNormal\"><strong>References:<\/strong><\/p>\n<ol>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Ranson JH. Acute pancreatitis: pathogenesis, outcome and treatment. Clin Gastroenterol. 1984 Sep;13(3):843-63. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/6386241\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Balthazar EJ: Acute pancreatitis: assessment of severity with clinical and CT evaluation. Radiology 2002;223:603. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/12034923\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/p>\n<\/li>\n<\/ol>\n<\/div>\n<p>&nbsp;<\/p>\n<p>Created: Jan 07, 2006<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[53],"tags":[231,230,16,15,1413,1008,1650,226,180,1375],"class_list":["post-2539","post","type-post","status-publish","format-standard","hentry","category-gastroenterology","tag-acute","tag-aguda","tag-criteria","tag-criterios","tag-gastroenterology","tag-pancreatitis","tag-ranson","tag-severidad","tag-severity","tag-uti"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2539","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=2539"}],"version-history":[{"count":3,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2539\/revisions"}],"predecessor-version":[{"id":9112,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2539\/revisions\/9112"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=2539"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=2539"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=2539"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}