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Context Assessment of tissue microcirculation is one of the important aspects of pathological evaluation in acute pancreatitis. Severe ischemic change sometimes leads to the development of organ dysfunction and/or infectious complications. Objective To evaluate the angiographic features of acute pancreatitis and correlate them with the severity of the disease. Design Retrospective study. Patients Twenty-seven consecutive patients with acute pancreatitis who had undergone angiography were retrospectively investigated. Main outcome measures Vascular findings and Ranson score. Results Ischemic changes were found in 18 patients (66.7%); 11 (40.7%) were severe changes. Pseudoaneurysm, bleeding, and staining were seen in 4 (14.8%), 2 (7.4%) and 5 (18.5%) patients, respectively. The rate ofsevere ischemic changes was significantly correlated with the Ranson score (P=0.012). Conclusions Angiographic findings are useful for the evaluation of severe acute pancreatitis.