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Table 3 CT Severity Index (Modified from: Balthazar EJ, Robinson DL, Megibow AJ, Ranson JH. Acute pancreatitis: value of CT in establishing prognosis. Radiology. 1990; 174:331–6 [27])

From: 2019 WSES guidelines for the management of severe acute pancreatitis

CT grade Grade score Definition
A 0 Normal pancreas
B 1 Pancreatic enlargement
C 2 Pancreatic inflammation and/or peripancreatic fat
D 3 Single peripancreatic fluid collection
E 4 ≥ 2 fluid collections and/or retroperitoneal air
% of necrosis Necrosis score Definition
 None 0 Uniform pancreatic enhancement
 < 30% 2 Non-enhancement of region(s) of gland equivalent in size of pancreatic head
 30–50% 4 Non-enhancement of 30–50% of the gland
 > 50% 6 Non-enhancement of over 50% of the gland
CT Severity Index Morbidity Mortality
 0–1 0 0
 2–3 8% 3%
 4–6 35% 6%
 7–10 92% 17%
  1. CT severity Index = grade score (0–4) + necrosis score (0–6)