Atlanta Classification Severe Pancreatitis — FRCA Final MCQ

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ModerateIntensive Care MedicineAtlanta Classification Severe PancreatitisFRCA Final

A 65-year-old man on ICU with acute pancreatitis develops multi-organ failure. His APACHE II score is 22. He requires mechanical ventilation, vasopressors, and renal replacement therapy. According to the revised Atlanta classification (2012), what severity category is this?

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Correct answer: B — Necrotising pancreatitis only

The revised Atlanta classification (2012) classifies acute pancreatitis severity as: MILD = no organ failure, no local or systemic complications; MODERATELY SEVERE = transient organ failure (<48 hours) OR local/systemic complications without persistent organ failure; SEVERE = persistent organ failure (>48 hours). Organ failure is defined using the modified Marshall scoring system (respiratory: PaO2/FiO2 ≤300; renal: creatinine ≥171; cardiovascular: systolic BP <90 despite fluids). This patient with multi-organ failure requiring ventilation, vasopressors, and RRT has SEVERE acute pancreatitis with a high mortality (30-50%).

Reference: Banks PA et al – 2012 – Revised Atlanta classification; IAP/APA – 2013 – Pancreatitis guidelines