Manish Manrai, Rakesh Kochhar, Ragesh Babu Thandassery, Abdulrahman A Alfadda, Saroj K Sinha
Until recently atlanta classification (1992) for severity stratification of acute pancreatitis has been widely followed. It has undergone a revision recently which has three categories of severity (mild, moderate and severe) with persistent organ failure as the key determinant of severity. Though the revised classification has brought uniformity in terminology and has been validated in recent studies, as its application has grown, a number of criticisms have arisen about it being complete. It has been pointed out that it does not give due credence to infected pancreatic necrosis and the dynamics of organ failure are not accounted for in it. The category of moderately severe pancreatitis is rather not well defined. Moreover the emerging data on extrapancreatic necrosis needs to be considered in severity stratification. This article analyses the clinical relevance of revised Atlanta classification in predicting severity and prognostication in acute pancreatitis and takes a look at the emerging data which highlights its shortcomings. The classification of acute pancreatitis seems to be a continuous process which is like a “work in progress”.
