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Fatal brain stem event complicating acute pancreatitis

C Chan1, J Fryer, G Herkes

  • 1Anatomical Pathology Department, Pacific Laboratory Medicine Services, Royal North Shore Hospital, Australia. charles.chan@email.cs.nsw.gov.au

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|May 24, 2003
PubMed

Insights

In a patient with chronic renal failure, acute pancreatitis led to a fatal neurological illness. Autopsy revealed unusual brain findings, suggesting a possible

Area of Science:

  • Neurology
  • Pathology
  • Nephrology

Background:

  • Acute pancreatitis can present with complex systemic complications.
  • Chronic renal failure poses challenges in managing pancreatitis and its sequelae.
  • Neurological complications in pancreatitis are rare but can be severe.

Observation:

  • A patient with chronic renal failure developed acute pancreatitis and a fatal neurological illness.
  • Neuroimaging (MRI) suggested pontine and extrapontine myelinolysis.
  • Autopsy findings were atypical, resembling acute haemorrhagic leucoencephalitis, termed 'pancreatic encephalopathy'.

Findings:

  • The autopsy confirmed acute pancreatitis.
  • Neuropathological findings were inconsistent with typical pontine and extrapontine myelinolysis.
  • The findings suggested an unusual presentation of acute haemorrhagic leucoencephalitis, possibly linked to pancreatic dysfunction.

Implications:

  • Autopsy remains crucial for diagnosing complex and rare neurological conditions, even with advanced imaging.
  • This case highlights the potential for unusual neurological manifestations of pancreatic disease.
  • Further research may elucidate the mechanisms of 'pancreatic encephalopathy'.

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