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The severity of an acute pancreatitis episode can be assessed using two tools: (1) Ranson/Imrie criteria...

Question

The severity of an acute pancreatitis episode can be assessed using two tools: (1) Ranson/Imrie criteria...

The severity of an acute pancreatitis episode can be assessed using two tools:

(1) Ranson/Imrie criteria and (2) modified Glasgow criteria. Describe each of these tools.

Answers

Ransons Crieria on admission

  • Age greater than 55 years.
  • A WBC count greater than 16000
  • Blood Glucose >11 mmol/L
  • Serum LDH>350 IU /L
  • Serum AST >250 IU /L

Ransons Criteria after 48 hours of admission.

  • Fall in hematocrit by more than 10%
  • Fluid sequestration of >6L
  • Hypocalcaemia <8.0mg/dl
  • Hypoxaemia (PO2<60mmHg)
  • Increase in BUN to >1.98 mmol/L after IV fluid hydration.
  • Base deficit of >4mmol/L

The prognostic implications of Ransons Criteria are as follows

  • Score 0 to 2 .2% mortality.
  • Score 3 to 4 15 mortality
  • Score 5 to 6 40% mortality
  • Score 7 to 8 100%mortality.

Modified Glas gow criteria

This is neurological scale which gives patient a score between 3-14 depending on their level of consciousness.the scale is composed of 3 tests Eye response,verbal response and Motor response.

Eye opening

  • No eye opening=1
  • Eye opening in response to pain stimulus=2
  • Eye opening to speech=3
  • Eye opening to spontaneously=4

Verbal Response

  • No verbal response.=1
  • Incomprehensible sounds.=2
  • Inappropriate words.=3
  • Confusion=4
  • Oriented.=5

Motor Response

  • No motor response=1
  • Decerebrate posturing accentuated by pain.=2
  • Decorticate posturing accentuated by pain =3
  • Withdrawl from pain.=4
  • Localizes to pain =5
  • Obeys command.=6


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