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Severe Acute Pancreatitis — RACP Adult Medicine MCQ

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ModerateGastroenterologySevere Acute PancreatitisRACP Adult Medicine

A 60-year-old man presents with acute pancreatitis. He develops persistent organ failure: mechanical ventilation for ARDS (PaO₂/FiO₂ <200 for 5 days), vasopressor-dependent shock, and AKI requiring dialysis. CT shows >50% pancreatic necrosis. What is the Revised Atlanta severity classification?

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Correct answer: B — Severe acute pancreatitis

Persistent organ failure (>48 hours) defines severe acute pancreatitis, which carries mortality of 20–40%. This patient has multi-organ failure (respiratory, cardiovascular, renal) and extensive necrosis. ICU management with nutritional support (nasojejunal feeding), and monitoring for infected necrosis (fine-needle aspiration if clinical suspicion) is required.

Reference: Revised Atlanta Classification 2012; GESA 2024 – Acute Pancreatitis