Infected pancreatic necrosis: Not necessarily a late event in acute pancreatitis

Table 1 Timing of pancreatic infection in the referred clinical studies n (%)

Study ID	Setting	No. of patients with confirmed IPN	Duration of disease at the time of diagnosing IPN
			Day 1-7	Day 8-14	Day 15+
Beger et al[8], 1986	Germany	45	5 (11)	8 (18)	32 (71)
Rattner et al[9], 1992	USA	44	2 (5)	10 (23)	32 (72)
Gerzof et al[10], 1987	USA	36	8 (22)	12 (33)	16 (45)
Tsui et al[16], 2009	China	65	1 (2)	15 (23)	49 (75)
Besselink et al[17], 2009	Netherlands	98	5 (5)	13 (13)	80 (82)
Overall		288	21 (7)	58 (20)	209 (73)

IPN: Infected pancreatic necrosis.

Table 2 The new classification of severity of acute pancreatitis (Modified from[2])

Severity category	Local determinants		Systemic determinants
Mild	No (peri)pancreatic necrosis	and	No organ failure
Moderate1	Sterile (peri)pancreatic necrosis	or	Transient organ failure
Severe1	Infected (peri)pancreatic necrosis	or	Persistent organ failure
Critical	Infected (peri)pancreatic necrosis	and	Persistent organ failure

¹Severity is graded on the basis of more severe local or systemic determinants (e.g. sterile pancreatic necrosis without organ failure has to be graded as moderate; sterile pancreatic necrosis with persistent organ failure has to be graded as severe).