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e-CASES: Balthazar modified score - CTSI

Dr Antoine Micheau , CHU Arnaud de Villeneuve , Montpellier , Herault , France

Balthazar's scoring system for severity of acute pancreatitis


Balthazar scoring based on CT :

Grade A: Normal CT - 0 points

Grade B: Focal or diffuse enlargement of the pancreas - 1 point

Grade C: Pancreatic gland abnormalities and peripancreatic inflammation - 2 points

Grade D: Fluid collection in a single location - 3 points

Grade E: Two or more fluid collections and / or gas bubbles in or adjacent to pancreas - 4 points


Necrosis Score based on percentage of necrosis on CT

No necrosis: 0 points

0 to 30% necrosis: 2 points

30 to 50% necrosis: 4 points

Over 50% necrosis :6 points


CT severity index = CT grade point + points for necrosis