Definitions of local, organ, and metabolic complications of severe acute pancreatitis
| Local and organ complications | |
|---|---|
| Shock | Pulse >100/min and systolic blood pressure <80 mm Hg for more than 10 minutes |
| Sepsis | Leucoctyes >12 g/l or <4 g/l; platelets <100 g/l; body temperature >38.5°C; positive blood culture; metabolic acidosis (base excess greater than −4 mmol/l) (4 of 5 criteria required) |
| Pulmonary insufficiency | Arterial Po 2 <8 kPa (60 mm Hg) (despite 4 litres O2/min via nasal tube) or need for mechanical ventilation |
| Renal insufficiency | Increase in serum creatinine to more than twice the normal value |
| Peritonitis | Intraoperative finding of suppurative intra-abdominal infection |
| Haemorrhage | Gastrointestinal and/or intra-abdominal bleeding requiring ⩾4 units |
| Abscess/infected pancreatic necrosis | Pus collection or infected fluid shown by ultrasound or CT guided fine needle aspiration and microbiological culture, or by (re)laparotomy |
| Fluid collection | Fluid collection with an extent of 5×5 cm or more on sonography or CT |
| Ileus/subileus | Clinical or radiological signs of intestinal paralysis or obstruction |
| Metabolic complications | |
| Hypocalcaemia | Calcium ⩽2.0 mmol/l |
| Coagulopathy | Prothrombin time <70% and/or partial thromboplastin time >45 seconds |
| Hyperglycaemia | Blood glucose level >8.4 mmol/l |
| Metabolic acidosis | Base excess greater than −4.0 mmol/l |
| Jaundice | Total serum bilirubin >20 μmol/l |
| Encephalopathy | Neuropsychiatric symptoms, abnormal electroencephalogram (except alcoholic delirium) |