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- W2129330152 abstract "Acutepancreatitis isnotonlylife-threatening in itself, butcanalso present awidevariety ofcomplicationsthatincrease itsmorbidity. Particularly challenging aretheextrapancreatic manifestations of thedisease, whicharerarely seen.Subcutaneous nodular fatnecrosis (Weber-Christian syndrome), ascites, pleural effusions, nephrosis, fatemboli, venous thromboses andfatnecrosis ofbonehave beendocumented recently (Lynch, 1954; Swerdlow, Berman, Gibbel, andValaitis, 1960;Lucasand Owens, 1962). Cerebral perivascular demyelination associated withacutehaemorrhagic pancreatitis hasbeen reported ononeprevious occasion (Vogel, 1951). However, other demyelinative encephalopathies have beendescribed asa result ofexcessive alcohol ingestion andinclude thesymmetrical demyelination ofthecorpus callosum described byMarchiafava and Bignami (1903), andcentral pontine myelinolysis recently described byAdams, Victor, andMancall, (1959). Thecasetobedescribed isthat ofamiddle-aged alcoholic malewithrelapsing pancreatitis who developed diffuse symmetrical demyelination ofthe ponsandcorpus callosum. CASEREPORT G.W.,a48-year-old Negromale, wasadmitted on4April 1965because ofsevere abdominal pain of20hours' duration. Hegaveahistory ofexcessive alcohol consumption forthree weeksbefore admission. Hewasaheavy drinker for25years, imbibing asmuchas30fluid ounces perday. In1951heunderwent anexploratory laparotomy for abdominal pain, andpancreatitits wasfound. In1958he washospitalized forfive dayswithadiagnosis ofduodenal ulcer andacutepancreatitis whichresponded to conservative management. Twenty hours before admission thepatient awokewithsevere stabbing epigastric pain unrelieved by antacids. Jaundice, melaena, cramps, haematemesis, oranantecedent history ofdiabetes or steatorrhea werenotpresent. Uponadmission, thepatient wasalert, butinpain, and appeared well-nourished withnoloss ofsubcutaneous fat. Temperature was374°C,pulse115/min andblood pressure 145/95 mm Hg.Lipaemia retinalis wasvisualized. No cutaneous xanthomata wereevident. Allperipheral pulses werebrisk. Therewasmoderate guarding inthe right upper quadrant oftheabdomen andslight distention andrebound tenderness intheepigastrium. A neurological examination wasunremarkable atthis timeand Chvostek's sign wasabsent. Adiagnosis ofacute pancreatitis wasmade.Laboratory findings included ahaematocrit of51%,specific gravity oftheurine was1-019, with noglucose present and1+ proteinuria, andnegative urinary sediment. Serumcreatinine concentration was 2-0mg %;serumamylase, 2,300 u.;cholesterol, 1,020 mg %;total lipids, 4,600 mg %;triglycerides, 2,615 mg %;leucine aminopeptidase, 780u.;SGOT820u.;SGPT, 270u.;total bilirubin, 0-3mg%;calcium, 50m-equiv/1.; bloodglucose, 420mg %.Treatment included nasogastric suction, intravenous fluids, B-vitamins, atropine, meperidine, penicillin, andchlortetracycline. Twelve hours after admission thepatient became hypotensive, febrile, andveryrestless. A positive Chvostek's sign developed withaserumcalcium of4-3m-equiv/1. andmagnesium of09m-equiv/1. Calcium gluconate and magnesium sulphate weregiven withlarge volumes of plasma andsaline fluid replacement. Regular insulin was" @default.
- W2129330152 created "2016-06-24" @default.
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- W2129330152 date "1968-12-01" @default.
- W2129330152 modified "2023-09-27" @default.
- W2129330152 title "Central pontine myelinolysis associated with acute haemorrhagic pancreatitis." @default.
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- W2129330152 doi "https://doi.org/10.1136/jnnp.31.6.583" @default.
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