Fatal cerebral hemorrhage associated with acute pancreatitis: A case report

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Abstract

Rationale:

Pancreatic encephalopathy (PE) refers to the abnormalities in mental status that complicate acute pancreatitis (AP). We report the case of a patient who developed AP that was complicated by PE and followed by fatal cerebral hemorrhage.

Patient concerns:

A 41-year-old male patient with AP that initially manifested with PE and was subsequently complicated by fatal cerebral hemorrhage.

Diagnoses:

A head computed tomography (CT) scan showed a fatal intracerebral hemorrhage located in the occipital lobe, and an abdominal CT scan presented a large amount of peripancreatic fluid collections.

Interventions:

The patient received a hematoma evacuation. The volume of the hematoma was approximately 15 mL. A consequent open pancreatic necrosectomy was performed to remove all necrotic tissues and to drain the peripancreatic fluid collections.

Outcomes:

The patient could perform his normal daily activities efficiently, and no abnormality was observed in the physical examination 3 months after his discharge.

Lessons:

Although uncommon, PE should be properly monitored. Once the neurological symptoms of a patient dramatically worsen within a short time, the possibility of fatal cerebral hemorrhage should be considered.

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