The clinical diagnostic aspects of acute pancreatic encephalopathy

Abstract

The pancreatic encephalopathy is characterized by various focal neurological symptomatic and sporadic fast development of dementia is considered as a rare complication of acute pancreatitis developing in 9-35% of patients with diseases of pancreas. Factually every patient with acute pancreatitis has a risk of development of pancreatic encephalopathy that significantly makes severer course of disease and increases lethality. The review article considers particular aspects of clinical manifestations and probable diagnostic algorithm of neurological disorders observed in patients with acute pancreatitis. The actuality of development of diagnostic algorithm of pancreatic encephalopathy is emphasized. This algorithm will permit ultimately early, probably at pre-clinical stage, discover the mentioned complication of acute pancreatitis with the purpose of not only ultimate early detection of pancreatic encephalopathy but also development of pathogenically conditioned therapeutic algorithm considering all chains of pathogenesis.

Keywords

review / pancreatic encephalopathy / pathogenesis / clinic / differentiated diagnostic / prognosis

References

[1] Мартынов Ю.С., Малкова Е.В., Кузнецов В.Н. Неврологические осложнения при панкреатитах. Журнал неврологии и психиатрии имени С.С. Корсакова. 1974; 74(6): 852-9.

[2] Akwe J.A., Westney G.E., Fongeh T.S. Pancreatic encephalopathy. Am. J. Case Rep. 2008; 9: 399-403.

[3] Nair R.J., Lawler L., Miller M.R. Chronic pancreatitis. Am. Fam. Physician. 2007; 76(11): 1679-88.

[4] Sun G.H., Yang Y.S., Liu Q.S., Cheng L.F., Huang X.S. Pancreatic encephalopathy and Wernicke encephalopathy in association with acute pancreatitis: a clinical study. World J. Gastroenterol. 2006; 12(26): 4224-7.

[5] Ruggieri R.M., Lupo L., Piccoli F. Pancreatic encephalopathy: a 7-year follow-up case report and review of the literature. Neurol. Sci. 2002; 23(4): 203-5.

[6] Jin S.L., Song X.W., Gu H.G. 13 cases of severe acute pancreatitis complicated with pancreatic encephalopathy. Shijie Huaren Xiaohua Zazhi. 2000; 8: 721-2

[7] Ohkubo T., Shiojiri T., Matsunaga T. Severe diffuse white matter lesions in a patient with pancreatic encephalopathy. J. Neurol. 2004; 251(4): 476-8.

[8] Sharma V., Sharma R., Rana S.S., Bhasin D.K. Pancreatic encephalopathy: an unusual cause of asterixis. JOP. 2014; 15(4): 383-4.

[9] Мерзликин Н.В., Бражникова Н.А., Цхай В.Ф. Панкреатит. М.: ГЭОТАР-Медиа; 2014.

[10] Савельев В.С., Филимонов М.И., Бурневич С.З. Острый панкреатит. В кн: Савельев В.С., Кириенко А.И., ред. Клиническая хирургия. Национальное руководство. Том II. М.: ГЭОТАР-Медиа; 2009: 196-228.

[11] Скоромец А.А., ред. Соматоневрология. Руководство для врачей. СПб.: СпецЛит; 2009.

[12] Arana-Guajardo A.C., Cámara-Lemarroy C.R., Rendón-Ramírez E.J., Jaquez-Quintana J.O., Góngora-Rivera J.F., Galarza-Delgado D.A. Wernicke encephalopathy presenting in a patient with severe acute pancreatitis. JOP. 2012; 13(1): 104-7.

[13] Zhang X.P., Tian H. Pathogenesis of pancreatic encephalopathy in severe acute pancreatitis. Hepatobiliary Pancreat. Dis. Int. 2007; 6(2): 134-40.

[14] Lekhra O.P., Maheshwari A., Rathore Y., Athale S. Page postpartum pancreatic encephalopathy - a rare case. J. Med. Dent. Sci. 2013; 6(2): 41-3.

[15] Tenenbein M.S., Tenenbein M. Acute pancreatitis due to erythromycin overdose. Pediatr. Emerg. Care. 2005; 21(10): 675-6.

[16] Raraty M.G., Murphy J.A., Mcloughlin E., Smith D., Criddle D., Sutton R. Mechanisms of acinar cell injury in acute pancreatitis. Scand. J. Surg. 2005; 94(2): 89-96.

[17] Pandol S.J. Acute pancreatitis. Curr. Opin. Gastroenterol. 2005; 21(5): 538-43

[18] Jiménez B., Montoliu C., MacIntyre D.A., Serra M.A., Wassel A., Jover M. et al. Serum metabolic signature of minimal hepatic encephalopathy by (1)H-nuclear magnetic resonance. J. Proteome Res. 2010; 9(10): 5180-7.

[19] Neoptolemos J.P., Bhutani M.S. Fast Facts: Diseases of the Pancreas and Biliary Tract. Oxford: Health press; 2006.

[20] Sharf B., Bental E. Pancreatic encephalopathy. J. Neurol. Neurosurg. Psychiatry. 1971; 34(3): 357-61.

[21] Алешина Е.Д., Коберская Н.Н., Дамулин И.В. Когнитивный вызванный потенциал Р300: методика, опыт применения, клиническое значение. Журнал неврологии и психиатрии имени С.С. Корсакова. 2009; 109(8): 77-84.

[22] Butterworth R.F. Pathophysiology of hepatic encephalopathy: a new look at ammonia. Metabol. Brain Dis. 2002; 17(4): 221-7.

[23] Hollerbach S., Kullmann F., Fründ R., Lock G., Geissler A., Schölmerich J. et al. Auditory event-related cerebral potentials (P300) in hepatic encephalopathy-topographic distribution and correlation with clinical and psychometric assessment. Hepatogastroenterology. 1997; 44(16): 1002-12.

[24] Ates F., Kosar F., Aksoy Y., Yildirim B., Sahin I., Hilmioglu F. QT in terval analysis in patients with acute biliary pancreatitis. Pancreas. 2005; 31(3): 238-41.

[25] Ramanathan R.S., Ahluwalia T. Necrotizing pancreatitis leading to pancreatic encephalopathy in a patient undergoing long-term continuous ambulatory peritoneal dialysis. J. Acad. Med. Sci. 2012; 2(2): 85-7.

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