Article Type : Clinical Image
Authors : De Reuck J
Keywords : Pancreatic Encephalopathy; Brain
Rothermich and Von Haam were the
first to describe the pancreatic encephalopathy in 1941. The diagnosis of
pancreatitis was determined by the high amylase levels in the blood and by the
pathological lesions observed during the cholecystectomy. A post-mortem
examination was performed in five patients, revealing diffuse areas of small
bleeds and perivascular demyelization in the brains [1]. Acute pancreatitis in
persons with alcohol abuse is observed in approximately 36% with a significant
male predominance [2].
We present a post-mortem 7.0-tesla magnetic resonance imaging (MRI) of the brain, of a 65-year old man with chronic liver cirrhosis who developed an acute pancreatitis with associated severe neuropsychiatric symptoms leading to death. Three coronal sections of a cerebral hemisphere and a horizontal section of a cerebellar were submitted to T2 and T2* MRI sequences.
The coronal sections of the
cerebral hemisphere show small patchy areas of white matter changes on the T2
sequence with in the frontal section on the T2* sequence an additional small
marginal bleed. Also some cortical micro- bleeds are detected in the 3 coronal
sections on the T2* sequence.
No white matter changes or cortical micro-bleeds are observed in the cerebellar section. The present study confirms the MRI findings observed in living patients with a “pure” pancreatic encephalopathy [3,4].
Acknowledgments
None.
Conflicts
of interest
The author declares no conflict of interest.
De Reuck J. Pancreatic encephalopathy. Adv
Clin Endo Met. 2018; 1: 7-15.