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Revista Colombiana de Cirugía

Print version ISSN 2011-7582On-line version ISSN 2619-6107


VELASQUEZ-CUASQUEN, Braulio Giovanni et al. Evaluation and analysis of the tomographic severity index and Atlanta 2012 classification in patients with severe acute pancreatitis. rev. colomb. cir. [online]. 2021, vol.36, n.3, pp.471-480.  Epub July 17, 2021. ISSN 2011-7582.


In patients with severe acute pancreatitis, the presence of infected necrosis and multiple organ failure are associated with a mortality of 20-40%. Computed tomography with intravenous contrast and the 2012 Atlanta Consensus classification are important diagnostic tools for timely treatment. In this research, the relationship between the tomographic severity index and the local morphological changes according to that classification, with the hospital stay, intervention, infection and mortality of the patients was analyzed.


Retrospective cohort study carried out between the years 2015 and 2019, which included patients older than 15 years with severe acute pancreatitis diagnosed by contrast computed tomography, the tomographic severity index and morphological changes according to the Atlanta 2012 classification were evaluated, in relationship with the clinical outcomes of the patients.


Fifty-six patients were included, in 82.1% (n=46) of the cases the cause was lithiasis. Organ failure was mainly pulmonary 53.6% (n=30) and cardiovascular 55.4% (n=31). According to the tomography, it was classified as severe (7-10) in 91.1% (n=51) of the patients. In patients with infected walled necrosis, the mean hospital stay was longer (78.5 days); infection was found in all patients with severe pancreatitis and they underwent some type of intervention. Mortality was less than 10% (n=5).


The tomographic severity index for the categorization of severity is 90% correlated with severe acute pancreatitis. A control tomography at the fourth week could identify late complications for early management.

Keywords : pancreatitis; complications; necrosis; infection; tomography; severity of illness index; mortality.

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