Revised Atlanta Classification of Acute Pancreatitis

Abstract

A revision of the original Atlanta Classification from 1992 was long awaited. With better understanding of the natural history and availability of better imaging tools, several limitations of this classification have been noted in different studies. In order to address these limitations and to propose a uniform classification based on modern concepts of acute pancreatitis (AP), an international working group initiated the process of a web-based reiterative consensus process in 2007. The consensus was published as the Revision of the Atlanta Classification of AP in 2013. According to the revised classification, AP has an early and a late phase with distinct clinical courses. Clear definitions of local and systemic complications have been proposed, and new terminologies for collections (acute peripancreatic fluid collections, pancreatic pseudocyst, acute necrotic collection, and walled-off necrosis) have been introduced. The severity of AP has been classified into three distinct categories, namely mild AP, moderately severe AP, and severe AP. This classification of severity is based on the presence or absence of local complications and organ failure and has been shown to have different clinical outcomes. Organ failure has been divided into transient ( 48 h) and the presence of only persistent organ failure qualifies the disease to be labeled as severe AP.