The diagnosis of acute and chronic pancreatitis should be made by histopathology, but this is usually impossible. Thus, the classification system proposed by the Cambridge and Marseille Symposia must suffice at the present time. Acute Pancreatitis: Diagnostic Criteria. 1. An elevation of plasma levels of pancreatic enzymes greater than ten standard deviations above the laboratory normal. 2. Evidence of acute pancreatitis from imaging, laparotomy, and/or autopsy. Clinical Classification. 1. Etiology where known (if unknown, this should be stated). 2. Degree of severity: (a) mild (no multisystem failure and uncomplicated recovery); (b) severe (multisystem failure and/or development of a complication that should be stated, for example, pseudocyst). Chronic Pancreatitis: Diagnostic Criteria. 1. Permanently impaired exocrine pancreatic function tests (greater than two standard deviations below the normal for the test). 2. Permanent morphological change in the gland. Clinical Classification. 1. Etiology where known (if unknown, this should be stated). 2. Pain present or absent. 3. Degrees of severity (mild, moderate, or severe changes in morphology and/or function). 4.
Complications: cysts, portal hypertension, diabetes mellitus, and so forth.