This site is targeted at medical and radiology professionals, contains user contributed content and material that may be confusing to a lay audience. Use of this site implies acceptance of our Terms of Use.

Balthazar score

Balthazar score is used in CT severity index (CTSI) for grading of acute pancreatitis. CTSI includes grading of pancreatitis (A-E) and the extent of pancreatic necrosis.


Grading of pancreatitis
  • A: normal pancreas: 0
  • B: enlargement of pancreas: 1
  • C: inflammatory changes in pancreas and peripancreatic fat: 2
  • D: ill defined single fluid collection: 3
  • E: two or more poorly defined fluid collections: 4
Pancreatic necrosis 
  • none: 0
  • less than/equal to 30%: 2
  • >30-50%: 4
  • >50%: 6

The maximum score that can be obtained is 10.

Stratification of pancreatitis severity
  • mild pancreatitis (interstitial pancreatitis): Balthazar B or C, without pancreatic or extrapancreatic necrosis
  • intermediate (exudative pancreatitis): Balthazar D or E, without pancreatic necrosis; peripancreatic collections are due to extrapancreatic necrosis
  • severe pancreatitis (necrotising): with pancreatic necrosis

Necrosis of the pancreas, visualised best on contrast enhanced CT as non-enhancing areas, is considered to represent severe pancreatitis.

Related articles

Updating… Please wait.


Error Unable to process the form. Check for errors and try again.

Alert_accept Thank you for updating your details.