Ranson's criteria and CT scoring system in Pancreatitis

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Present on Admission - GA LAW

Blood Glucose greater than 200 mg/dl
Age greater than 55 years
Serum LDH greater than 350 I.U./L
SGOT (AST) greater than 250 I.U./L
WBC greater than 16,000/ul

NB - Amylase is NOT one of Ranson's criteria!
# Serum amylase has low sensitivity and specificity
# 20% cases of pancreatitis have normal serum amylase (particularly alcoholic aetiology)


Developing During the First 48 Hours: - C HOBBS

Serum Calcium less than 8 mg/dl
Hematocrit fall greater than 10%
Arterial Oxygen saturation less than 60 mm Hg
BUN increase greater than 8 mg/dl
Base deficit greater than 4 meq/L
Estimated fluid Sequestration greater than 600 ml

*Ranson score of 0-2, minimal mortality
*Ranson score of 3-5, 10%-20% mortality
*Ranson score of >5 has more than 50% mortality and is associated with more systemic complications.

Contrast-enhanced CT scoring system
Grade........................................... Criteria
A ................................ .......... ............. Normal
B ................................. Focal or diffuse glandular enlargement

Small intra-pancreatic fluid collection

C ....................................................... Any of the above

Peripancreatic inflammatory changes

Less than 25% gland necrosis

D ............................ .................................Any of the above

Single extrapancreatic fluid collection

25-50% gland necrosis

E ....................... .......................................... Any of the above

Extensive extrapancreatic fluid collection
Pancreatic abscess
More than 50% gland necrosis