To date, there are several classifications of pancreatonecrosis, among which the most popular is the classification adopted since 1992 in Atlanta and the classification proposed by Saveliev, which is more popular in Russia. As for the stages of the course of the disease, here experts hold a common opinion.
The inconsistency between different specialists in the classification and division of the disease into stages is associated with different ideas about the pathomorphology of the disease and the lack of opportunities to verify and confirm the proposed clinical forms.
For a more accurate picture, this disease can be considered much more detailed than prescribed in these classifications.
Classification of pancreatonecrosis
Because pancreatic necrosis is a complication of acute pancreatitis, the etiology of this disease is always secondary.
1) Distribution classification:
- Local( one anatomical area is affected);
- Diffuse( diseases subject to more than two anatomical areas of the pancreas).
2) According to the depth of the disease:
- Surface;
- Deep;
- Total.
3) By the nature of the course of the disease:
- Recurrent;
- Abortive;
- Regressing;
- Progressive;
- Lightning fast.
4) Classification by toxic system reaction:
- Mono-organ failure;
- Multiple organ failure.
5) By severity:
- Easy degree. It is characteristic for edematous or diffuse small-focal pancreatonecrosis.
- Average degree. It is characteristic for local or diffuse large-focal pancreatic necrosis.
- Heavy. It is characteristic of large-focus, diffuse and total pancreonecrosis.
- Extremely severe. It is typical for total pancreatic necrosis with complications.
6) Classification by pathogenetic form:
- Post-traumatic;
- Contact;
- Angiogenic;
- Immuno-dependent;
- Cholecystogenic;
- Billing.
Pancreatonecrosis stages
This disease develops in three stages:
- Toxemia is the first stage of this disease and is characterized by the appearance in the blood of a patient of toxins of bacterial origin.
- The second stage of pancreatic necrosis is the formation of an abscess in the pancreas and the organs next to it.
- In the third stage of the disease, purulent lesions in the tissues begin.
Pancreatonecrosis for ICD-10
The International Classification of Diseases of the latest, 10 revision( ICD-10) was approved in 2007 by the World Health Organization. This method of classification was adopted to facilitate understanding between medical professionals around the world. It is a multi-level encoding, consisting of 21 sections and many subsections characterizing pathological conditions and diseases.
According to ICD-10, pancreatonecrosis has the code K86.8.1.Cipher means that the disease refers to diseases of the digestive system( section XI( K)), affecting the gallbladder, pancreas or bile duct( Block K80-K87).Namely the pancreas( K86).Further coding implies that pancreatic necrosis belongs to the group of "Other specified pancreatic pathologies"( K86.8).The last figure of the cipher indicates a specific disease - pancreonecrosis( K86.8.1.).At the same time, the classification shows that it can be fatty, aseptic and BDU( without additional clarification).
Thus, the knowledge of ICD-10 ciphers will allow any doctor, regardless of the language and country of residence used, to understand his colleague, for which the classification was created.