Balthazar CT Severity Index
Estimates acute pancreatitis severity from computed tomography and necrosis.
When to use
Acute pancreatitis in adults with contrast enhanced computed tomography, to estimate morphologic severity.
Pearls and pitfalls
- The CT grade ranges from A to E and scores 0 to 4 points.
- Necrosis adds 2, 4 or 6 points depending on extent.
- Early CT may underestimate necrosis; reassess if the clinical picture worsens.
- The score does not replace clinical criteria or organ dysfunction assessment.
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Formula
Add the CT grade (A to E, 0 to 4) and the necrosis score (0, 2, 4 or 6).
Evidence
CT severity index derived to correlate CT findings and necrosis with prognosis in acute pancreatitis.
References
- Balthazar EJ, Robinson DL, Megibow AJ, Ranson JH. Acute pancreatitis: value of CT in establishing prognosis. Radiology. 1990;174(2):331-336. doi:10.1148/radiology.174.2.2296641
Frequently asked questions
What is Balthazar CT Severity Index?
Estimates acute pancreatitis severity from computed tomography and necrosis. Acute pancreatitis in adults with contrast enhanced computed tomography, to estimate morphologic severity.
How is the result calculated?
Add the CT grade (A to E, 0 to 4) and the necrosis score (0, 2, 4 or 6).
How should the result be interpreted?
CT severity index derived to correlate CT findings and necrosis with prognosis in acute pancreatitis.
What are the sources?
Balthazar EJ, Robinson DL, Megibow AJ, Ranson JH. Acute pancreatitis: value of CT in establishing prognosis. Radiology. 1990;174(2):331-336.