Balthazar score

The Balthazar score is a subscore within the CT severity index (CTSI) for grading of acute pancreatitis

The CTSI sums two scores:

  • Balthazar score: grading of pancreatitis (A-E)
  • grading the extent of pancreatic necrosis

The Balthazar score was originally used alone, but the addition of a score for pancreatic necrosis improved correlation with clinical severity scores.

The CTSI has since been updated to the modified CTSI (2004).

CTSI

Grading of pancreatitis (Balthazar score)
  • A: normal pancreas: 0
  • B: enlargement of pancreas: 1
  • C: inflammatory changes in pancreas and peripancreatic fat: 2
  • D: ill defined single peripancreatic fluid collection: 3
  • E: two or more poorly defined peripancreatic 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): necrosis of the pancreas (non-enhancing areas in the pancreas on contrast-enhanced CT)

Treatment and prognosis

There is good correlation of clinical pancreatitis scores and current CT pancreatitis severity scores (such as the CTSI and modified CTSI) so imaging is not always necessary for to assess the severity of pancreatitis 3.


Pancreatic pathology
Edit Article Share
URL of Article

Article Information:

rID: 22953
Section: Classifications
Synonyms or Alternate Spellings:
  • Balthazar's score
  • Drag
    Case 1: Balthazar E
    Drag here to reorder.
  • Drag
    Case 2: Balthazar E
    Drag here to reorder.
  • Drag
    Case 3: Balthazar C
    Drag here to reorder.
  • Drag
    Case 4: Balthazar E
    Drag here to reorder.
  • Updating… Please wait.
    Loadinganimation

    Alert_accept

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

    Alert_accept Thank you for updating your details.