An Overview of Acute Pancreatitis: Role of the Prediction Scores for the Assessment of Severity
Giuseppe Evola, Marco Vacante, Francesco Roberto Evola, Giuseppe Angelo Reina, Grazia Maugeri, Giuseppe Musumeci, Velia D'Agata, Guido BasileReview Articles, no. 3, 2025
Article DOI: 10.21614/chirurgia.3117
Acute pancreatitis is a serious inflammatory condition of the pancreas that can be life-threatening, with the approach to treatment depending on the severity of the disease. Diagnosing acute pancreatitis, predicting its severity, and assessing prognosis generally involve imaging techniques like computed tomography, magnetic resonance imaging and ultrasound, along with scoring systems such as Ranson, Acute Physiology and Chronic Health Evaluation II (APACHE II), and the Bedside Index for Severity in Acute Pancreatitis (BISAP).
Computed tomography is regarded as the gold standard due to its high sensitivity and specificity, while magnetic resonance imaging and ultrasound offer valuable insights into biliary obstruction and vascular issues. These scoring systems help categorize patients based on clinical and laboratory data into mild, moderate, or severe levels, influencing treatment decisions like intensive care unit admission, early enteral feeding, and the use of antibiotics. However, despite the importance of these imaging and scoring methods in managing acute pancreatitis, they face challenges in terms of accuracy, consistency, practicality, and cost-effectiveness. In this review we aimed at discussing the clinical usefulness of the most important scoring systems for prediction of severity in this complex disease.
Computed tomography is regarded as the gold standard due to its high sensitivity and specificity, while magnetic resonance imaging and ultrasound offer valuable insights into biliary obstruction and vascular issues. These scoring systems help categorize patients based on clinical and laboratory data into mild, moderate, or severe levels, influencing treatment decisions like intensive care unit admission, early enteral feeding, and the use of antibiotics. However, despite the importance of these imaging and scoring methods in managing acute pancreatitis, they face challenges in terms of accuracy, consistency, practicality, and cost-effectiveness. In this review we aimed at discussing the clinical usefulness of the most important scoring systems for prediction of severity in this complex disease.
Keywords: acute pancreatitis, pancreatitis, scoring system, pancreatic disease



