Related Experiment Video
Updated: Feb 26, 2026
Author Spotlight: Advancements in Retroperitoneal Approach for Necrotizing Pancreatitis
Published on: March 15, 2024
Describing Peripancreatic Collections According to the Revised Atlanta Classification of Acute Pancreatitis: An
Stefan A Bouwense1, Sandra van Brunschot, Hjalmar C van Santvoort
1From the *Department of OR/Clinical Surgical Research, Radboud university medical center, Nijmegen; Departments of †Gastroenterology and Hepatology, and ‡Surgery, Academic Medical Center, Amsterdam; §Department of Radiology, St. Antonius Hospital, Nieuwegein; ∥Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands; ¶Department of Gastroenterology, Center for Pancreatic Disease, Brigham and Women's Health Hospital, Harvard Medical School, Boston, MA; #Department of Radiology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands; **Department of Surgery, Glasgow Royal Infirmary, Glasgow; ††Department of Surgery, Freeman Hospital, Newcastle Upon Tyne, United Kingdom; ‡‡Department of Surgery, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands; §§Department of Radiology, University of Washington Medical Center, Seattle, WA; ∥∥Department of Radiology, Radboud university medical center, Nijmegen, The Netherlands; ¶¶Department of Radiology, Mayo Clinic, Rochester, MN; ##Department of Surgery, University Hospital Southampton, Hampshire, United Kingdom; ***Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands; †††Department of Medicine A, University Medicine Greifswald, Germany; ‡‡‡Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA; §§§Department of Surgery, Mayo Clinic, Rochester, MN; ∥∥∥Department of Radiology, University Hospital Southampton, Hampshire, United Kingdom; ¶¶¶Department of Gastroenterology, Mayo Clinic, Rochester, MN; ###Department of Surgery, Ludwig Maximilian University of Munich, Munich, Germany; ****Department of Clinical Research Unit, Academic Medical Center, Amsterdam, The Netherlands; and ††††Department of Surgery, University of Washington Medical Center, Seattle, WA.
Objectives:
Severe acute pancreatitis is associated with peripancreatic morphologic changes as seen on imaging. Uniform communication regarding these morphologic findings is crucial for accurate diagnosis and treatment. For the original 1992 Atlanta classification, interobserver agreement is poor. We hypothesized that for the revised Atlanta classification, interobserver agreement will be better.
Methods:
An international, interobserver agreement study was performed among expert and nonexpert radiologists (n = 14), surgeons (n = 15), and gastroenterologists (n = 8). Representative computed tomographies of all stages of acute pancreatitis were selected from 55 patients and were assessed according to the revised Atlanta classification. The interobserver agreement was calculated among all reviewers and subgroups, that is, expert and nonexpert reviewers; interobserver agreement was defined as poor (≤0.20), fair (0.21-0.40), moderate (0.41-0.60), good (0.61-0.80), or very good (0.81-1.00).
Results:
Interobserver agreement among all reviewers was good (0.75 [standard deviation, 0.21]) for describing the type of acute pancreatitis and good (0.62 [standard deviation, 0.19]) for the type of peripancreatic collection. Expert radiologists showed the best and nonexpert clinicians the lowest interobserver agreement.
Conclusions:
Interobserver agreement was good for the revised Atlanta classification, supporting the importance for widespread adaption of this revised classification for clinical and research communications.
Related Concept Videos
01:30Acute Pancreatitis II: Clinical Manifestations and Management
01:27Acute Pancreatitis I: Introduction
Acute pancreatitis is characterized by rapid inflammation of the pancreas, often caused by factors like gallstone blockage or excessive alcohol consumption. Chronic pancreatitis, on the other hand, is a slow, progressive inflammation that may result from long-term alcohol abuse, obstructions in the pancreatic duct, or genetic factors.
The causes of acute pancreatitis include:
01:29Chronic Pancreatitis II: Collaborative Care
Assessment:
01:24Chronic Pancreatitis I: Introduction
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...