Revised Atlanta classification for acute pancreatitis: A pictorial essay

Bryan Foster, Kyle Jensen, Gennadiy Bakis, Akram M. Shaaban, Fergus Coakley

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

The 2012 revised Atlanta classification is an update of the original 1992 Atlanta classification, a standardized clinical and radiologic nomenclature for acute pancreatitis and associated complications based on research advances made over the past 2 decades. Acute pancreatitis is now divided into two distinct subtypes, necrotizing pancreatitis and interstitial edematous pancreatitis (IEP), based on the presence or absence of necrosis, respectively. The revised classification system also updates confusing and sometimes inaccurate terminology that was previously used to describe pancreatic and peripancreatic collections. As such, use of the terms acute pseudocyst and pancreatic abscess is now discouraged. Instead, four distinct collection subtypes are identified on the basis of the presence of pancreatic necrosis and time elapsed since the onset of pancreatitis. Acute peripancreatic fluid collections (APFCs) and pseudocysts occur in IEP and contain fluid only. Acute necrotic collections (ANCs) and walled-off necrosis (WON) occur only in patients with necrotizing pancreatitis and contain variable amounts of fluid and necrotic debris. APFCs and ANCs occur within 4 weeks of disease onset. After this time, APFCs or ANCs may either resolve or persist, developing a mature wall to become a pseudocyst or a WON, respectively. Any collection subtype may become infected and manifest as internal gas, though this occurs most commonly in necrotic collections. In this review, the authors present a practical image-rich guide to the revised Atlanta classification system, with the goal of fostering implementation of the revised system into radiology practice, thereby facilitating accurate communication among clinicians and reinforcing the radiologist’s role as a key member of a multidisciplinary team in treating patients with acute pancreatitis.

Original languageEnglish (US)
Pages (from-to)675-687
Number of pages13
JournalRadiographics
Volume36
Issue number3
DOIs
StatePublished - May 1 2016

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Pancreatitis
Necrosis
Terminology
Pancreatic Pseudocyst
Foster Home Care
Radiology
Abscess
Gases
Communication
Research

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Revised Atlanta classification for acute pancreatitis : A pictorial essay. / Foster, Bryan; Jensen, Kyle; Bakis, Gennadiy; Shaaban, Akram M.; Coakley, Fergus.

In: Radiographics, Vol. 36, No. 3, 01.05.2016, p. 675-687.

Research output: Contribution to journalArticle

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