Keywords
pancreatic encephalopathy, pathogenesis, clinical features, differential diagnosis, prognosis
How to Cite
Damulin, I. V., StrutsenkoА. А., Ogurtsov, P. P., & Mazurchik, N. V. (2017). Pancreatic encephalopathy: clinical, pathogenetic and diagnostic aspects. Herald of Pancreatic Club, 37(4), 33-39. https://doi.org/10.33149/vkp.2017.04.05
Abstract views: 706 PDF Downloads: 1576 PDF Downloads: 166
Abstract
Pancreatic encephalopathy occurs in 9–35% of patients with pancreatic diseases and is characterized by a variety of focal neurological symptoms. Neuropsychiatric disorders are observed both during the acute and latent period of the pancreatic diseases. The presence of pancreatic encephalopathy should be suspected if patients with symptoms of acute pancreatitis have neurological symptoms. The course of acute pancreatic encephalopathy is cyclical, fluctuating, being in direct proportion to the pancreatic process. Leading mechanism in the development of pancreatic encephalopathy is a combination of hyperenzymemia with insulin imbalance which leads to changes of water-electrolyte balance and carbohydrate metabolism. Infectious complications, that often accompany acute pancreatitis, lead to the increasing intoxication syndrome.
References
1. Агапов К. В. Диагностика и лечение панкреонекроза. Экономическое обоснование рациональной хирургической тактики : дис. на соиск. ученой степени д. мед. н. / К. В. Агапов. – М., 2012.
2. Алешина Е. Д. Когнитивный вызванный потенциал Р300: методика, опыт применения, клиническое значение / Е. Д. Алешина, Н. Н. Коберская, И. В. Дамулин // Жур. неврологии и психиатр. им. С. С. Корсакова. – 2009. – № 109 (8). – С. 77–84.
3. Савельев В. С. Острый панкреатит / В. С. Савельев, М. И. Филимонов, С. З. Бурневич // Клиническая хирургия. Национальное руководство / Под ред. В. С. Савельева, А. И.Кириенко. – М. : ГЭОТАР-Медиа, 2009. – Т. ΙΙ. – 832 c.
4. Соматоневрология. Руководство для врачей / Под ред. А. А. Скоромца. –М. : СпецЛит, 2009. – 655 c.
5. Acute pancreatitis due to erythromycin overdose / M. S. Tenenbein, M. Tenenbein // Pediatr. Emerg. Care. – 2005. – Vol. 21. – P. 675–676.
6. Akwe J. A. Pancreatic encephalopathy / J. A. Akwe, G. E. Westney, T. S. Fongeh // The Amer. J. Case Report. – 2008. – Vol. 9. – P. 399–403.
7. Akwe J. A. Pancreatic encephalopathy / J. A. Akwe, G. E. Westney, T. S Fongeh // Am. J. Case Rep. – 2008. – Vol. 9. – P. 399–400.
8. A case of indometacin-induced acute hepatitis developing into chronic autoimmune hepatitis / C. Abraham, J. Hart, S. M. Locke, A. L. Baker // Nature Clinical Practice Gastroenterology & Hepatology. – 2008. – Vol. 5. – P. 172–176.
9. Hollerbach S. Auditory event-related cerebral potentials (P300) in hepatic encephalopathy-topographic distribution and correlation with clinical and psychometric assessment / S. Hollerbach, F. Kullmann, R. Fründ // Hepatogastroenterol. – 1997. – Vol. 44, No 16. – P. 1002–1012.
10. Jin S. L. 13 cases of severe acute pancreatitis complicated with pancreatic encephalopathy / S. L. Jin, X. W. Song, H. G. Gu // Shijie Huaren Xiaohua Zazhi. – 2000. – Vol. 8. – P. 721–722.
11. Johnson D. A. Pancreatic encephalopathy / Johnson D. A., Tong N. T. // South Med. J. – 1977. – Vol. 70. – P. 165–167.
12. Mechanisms of acinar cell injury in acute pancreatitis / M. G. Raraty, J. A. Murphy, E. Mcloughlin [et al.] // Scand. J. Surg. – 2005. – Vol. 94. – P. 89–96.
13. Neoptolemos J. P. Fast facts: diseases of the pancreas and biliary tract / J. P. Neoptolemos, M. S. Bhutani. – Oxford : Health press, 2006. – 128 p.
14. Ohkubo T. Severe diffuse white matter lesions in a patient with pancreatic encephalopathy / T. Ohkubo, T. Shiojiri, T. Matsunaga // J. Neurol. – 2004. – Vol. 251. – P. 476–478.
15. Page postpartum pancreatic encephalopathy – a rare case / O. P. Lekhra, A. Maheshwari, Y. Rathore, S. Athale // J. Dental Med. Sci. – 2013. – Vol. 6, No 2. – P. 41–43.
16. Pancreatic encephalopathy and Wernicke encephalopathy in association with acute pancreatitis : a clinical study / G. H. Sun, Y. S. Yang, Q. S. Liu [et al.] // World J. Gastroenterol. – 2006. – Vol. 12. – P. 4224–4227.
17. Pancreatic encephalopathy: about 2 cases and review of the literature / N. Doghmi, A. Benakrout, A. Meskine [et al.] // Pan. Afr. Med. J. – 2016. – Vol. 25. – P. 147.
18. Pancreatic encephalopathy: an unusual cause of asterixis / V. Sharma, R. Sharma, S. S. Rana, D. K. Bhasin // J. Pancreas (Online). – 2014. – Vol. 15, No 4. – P. 383–384.
19. Pandol S. J. Acute pancreatitis / S. J. Pandol // Curr. Opin. Gastroenterol. – 2005. – Vol. 21. – P. 538–543.
20. QT interval analysis in patients with acute biliary pancreatitis / F. Kosar, F. Ates, I. Sahin [et al.] // Pancreas. – 2005. – Vol. 31. – P. 238–241.
21. Ramanathan R. S., Ahluwalia T. Necrotizing pancreatitis leading to pancreatic encephalopathy in a patient undergoing long-term continuous ambulatory peritoneal dialysis / R. S. Ramanathan, T. Ahluwalia // J. Acad. Med. Sci. – 2012. – Vol. 2, No 2. – P. 85–87.
22. Ruggieri R. M. Pancreatic encephalopathy : a 7-year follow-up case report and review of the literature / R. M. Ruggieri, L. Lupo, F. Piccoli // Neurol. Sci. – 2002. – Vol. 23. – P. 203–205.
23. Serum metabolic signature of minimal hepatic encephalopathy by (1)H-nuclear magnetic resonance / Jiménez B., Montoliu C., MacIntyre D. A. [et al.] // J. Proteome Res. – 2010. – Vol. 9, No 10. – P. 5180–5187.
24. Sharf B. Pancreatic encephalopathy / B. Sharf, E. Bental // J. Neurol. Neurosurg. – Psychiatry. – 1971. – Vol. 34. – P. 357–361.
25. Wernicke encephalopathy presenting in a patient with severe acute pancreatitis / A. C. Arana-Guajardo, C. R. Cámara-Lemarroy, E. J. Rendón-Ramírez [et al.] // J. Pancreas. – 2012. – Vol. 13, No 1. – P. 104–107.
26. Zhang X.-P. Pathogenesis of pancreatic encephalopathy in severe acute pancreatitis / X.-P. Zhang, H. Tian // Hepatobiliary Pancreat. Dis. Int. – 2007. – Vol. 6. – P. 134–140.
2. Алешина Е. Д. Когнитивный вызванный потенциал Р300: методика, опыт применения, клиническое значение / Е. Д. Алешина, Н. Н. Коберская, И. В. Дамулин // Жур. неврологии и психиатр. им. С. С. Корсакова. – 2009. – № 109 (8). – С. 77–84.
3. Савельев В. С. Острый панкреатит / В. С. Савельев, М. И. Филимонов, С. З. Бурневич // Клиническая хирургия. Национальное руководство / Под ред. В. С. Савельева, А. И.Кириенко. – М. : ГЭОТАР-Медиа, 2009. – Т. ΙΙ. – 832 c.
4. Соматоневрология. Руководство для врачей / Под ред. А. А. Скоромца. –М. : СпецЛит, 2009. – 655 c.
5. Acute pancreatitis due to erythromycin overdose / M. S. Tenenbein, M. Tenenbein // Pediatr. Emerg. Care. – 2005. – Vol. 21. – P. 675–676.
6. Akwe J. A. Pancreatic encephalopathy / J. A. Akwe, G. E. Westney, T. S. Fongeh // The Amer. J. Case Report. – 2008. – Vol. 9. – P. 399–403.
7. Akwe J. A. Pancreatic encephalopathy / J. A. Akwe, G. E. Westney, T. S Fongeh // Am. J. Case Rep. – 2008. – Vol. 9. – P. 399–400.
8. A case of indometacin-induced acute hepatitis developing into chronic autoimmune hepatitis / C. Abraham, J. Hart, S. M. Locke, A. L. Baker // Nature Clinical Practice Gastroenterology & Hepatology. – 2008. – Vol. 5. – P. 172–176.
9. Hollerbach S. Auditory event-related cerebral potentials (P300) in hepatic encephalopathy-topographic distribution and correlation with clinical and psychometric assessment / S. Hollerbach, F. Kullmann, R. Fründ // Hepatogastroenterol. – 1997. – Vol. 44, No 16. – P. 1002–1012.
10. Jin S. L. 13 cases of severe acute pancreatitis complicated with pancreatic encephalopathy / S. L. Jin, X. W. Song, H. G. Gu // Shijie Huaren Xiaohua Zazhi. – 2000. – Vol. 8. – P. 721–722.
11. Johnson D. A. Pancreatic encephalopathy / Johnson D. A., Tong N. T. // South Med. J. – 1977. – Vol. 70. – P. 165–167.
12. Mechanisms of acinar cell injury in acute pancreatitis / M. G. Raraty, J. A. Murphy, E. Mcloughlin [et al.] // Scand. J. Surg. – 2005. – Vol. 94. – P. 89–96.
13. Neoptolemos J. P. Fast facts: diseases of the pancreas and biliary tract / J. P. Neoptolemos, M. S. Bhutani. – Oxford : Health press, 2006. – 128 p.
14. Ohkubo T. Severe diffuse white matter lesions in a patient with pancreatic encephalopathy / T. Ohkubo, T. Shiojiri, T. Matsunaga // J. Neurol. – 2004. – Vol. 251. – P. 476–478.
15. Page postpartum pancreatic encephalopathy – a rare case / O. P. Lekhra, A. Maheshwari, Y. Rathore, S. Athale // J. Dental Med. Sci. – 2013. – Vol. 6, No 2. – P. 41–43.
16. Pancreatic encephalopathy and Wernicke encephalopathy in association with acute pancreatitis : a clinical study / G. H. Sun, Y. S. Yang, Q. S. Liu [et al.] // World J. Gastroenterol. – 2006. – Vol. 12. – P. 4224–4227.
17. Pancreatic encephalopathy: about 2 cases and review of the literature / N. Doghmi, A. Benakrout, A. Meskine [et al.] // Pan. Afr. Med. J. – 2016. – Vol. 25. – P. 147.
18. Pancreatic encephalopathy: an unusual cause of asterixis / V. Sharma, R. Sharma, S. S. Rana, D. K. Bhasin // J. Pancreas (Online). – 2014. – Vol. 15, No 4. – P. 383–384.
19. Pandol S. J. Acute pancreatitis / S. J. Pandol // Curr. Opin. Gastroenterol. – 2005. – Vol. 21. – P. 538–543.
20. QT interval analysis in patients with acute biliary pancreatitis / F. Kosar, F. Ates, I. Sahin [et al.] // Pancreas. – 2005. – Vol. 31. – P. 238–241.
21. Ramanathan R. S., Ahluwalia T. Necrotizing pancreatitis leading to pancreatic encephalopathy in a patient undergoing long-term continuous ambulatory peritoneal dialysis / R. S. Ramanathan, T. Ahluwalia // J. Acad. Med. Sci. – 2012. – Vol. 2, No 2. – P. 85–87.
22. Ruggieri R. M. Pancreatic encephalopathy : a 7-year follow-up case report and review of the literature / R. M. Ruggieri, L. Lupo, F. Piccoli // Neurol. Sci. – 2002. – Vol. 23. – P. 203–205.
23. Serum metabolic signature of minimal hepatic encephalopathy by (1)H-nuclear magnetic resonance / Jiménez B., Montoliu C., MacIntyre D. A. [et al.] // J. Proteome Res. – 2010. – Vol. 9, No 10. – P. 5180–5187.
24. Sharf B. Pancreatic encephalopathy / B. Sharf, E. Bental // J. Neurol. Neurosurg. – Psychiatry. – 1971. – Vol. 34. – P. 357–361.
25. Wernicke encephalopathy presenting in a patient with severe acute pancreatitis / A. C. Arana-Guajardo, C. R. Cámara-Lemarroy, E. J. Rendón-Ramírez [et al.] // J. Pancreas. – 2012. – Vol. 13, No 1. – P. 104–107.
26. Zhang X.-P. Pathogenesis of pancreatic encephalopathy in severe acute pancreatitis / X.-P. Zhang, H. Tian // Hepatobiliary Pancreat. Dis. Int. – 2007. – Vol. 6. – P. 134–140.