Acute Pancreatitis and Posterior Reversible Encephalopathy Syndrome: A Case Report
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7368 |
Resumo: | The posterior reversible encephalopathy syndrome is a neurological syndrome characterized by headache, confusion, visual disturbances and seizures associated with identifiable areas of cerebral edema on imaging studies. The authors report the case of a man, 33 years-old, leukodermic with a history of chronic alcohol and tobacco consumption, who is admitted to the emergency department for epigastric pain radiating to the back and vomiting with about six hours of evolution and an intense holocranial headache for two hours. His physical examination was remarkable for a blood pressure of 190/100 mmHg and tenderness in epigastrium. His analytical results revealed emphasis on amylase 193 U/L and lipase 934 U/L. During the observation in the emergency department,he presented a generalized tonic-clonic seizure. Abdominal ultrasonography was performed and suggestive of pancreatitis withoutgallstones signals. Head computed tomography showed subarachnoid haemorrhage and a small right frontal cortical haemorrhage. The brain magnetic resonance imaging done one week after admission showed areas of a bilateral and symmetrical T2 / FLAIR hyperintensities in the subcortical white matter of the parietal and superior frontal regions, suggesting a diagnosis of posterior reversible encephalopathy syndrome. Abdominal computed tomography (10 days after admission) demonstrated a thickened pancreas in connection with inflammation and two small hypodense foci in the anterior part of the pancreas body, translating small foci of necrosis. The investigation of a thrombophilic defect revealed a heterozygous G20210A prothrombin gene mutation. The patient was discharged without neurological sequelae and asymptomatic. The follow-up brain magnetic resonance imaging confirmed the reversal of the lesions, confirming the diagnosis. |
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Acute Pancreatitis and Posterior Reversible Encephalopathy Syndrome: A Case ReportPancreatite Aguda e Síndrome de Encefalopatia Posterior Reversível: Relato de um CasoAlcoholism/complicationsBrain EdemaPancreatitisAlcoholicPosterior Leukoencephalopathy Syndrome.Alcoolismo/complicaçõesEdema CerebralPancreatite AlcoólicaSíndrome de Enfalopatia Posterior Reversível.The posterior reversible encephalopathy syndrome is a neurological syndrome characterized by headache, confusion, visual disturbances and seizures associated with identifiable areas of cerebral edema on imaging studies. The authors report the case of a man, 33 years-old, leukodermic with a history of chronic alcohol and tobacco consumption, who is admitted to the emergency department for epigastric pain radiating to the back and vomiting with about six hours of evolution and an intense holocranial headache for two hours. His physical examination was remarkable for a blood pressure of 190/100 mmHg and tenderness in epigastrium. His analytical results revealed emphasis on amylase 193 U/L and lipase 934 U/L. During the observation in the emergency department,he presented a generalized tonic-clonic seizure. Abdominal ultrasonography was performed and suggestive of pancreatitis withoutgallstones signals. Head computed tomography showed subarachnoid haemorrhage and a small right frontal cortical haemorrhage. The brain magnetic resonance imaging done one week after admission showed areas of a bilateral and symmetrical T2 / FLAIR hyperintensities in the subcortical white matter of the parietal and superior frontal regions, suggesting a diagnosis of posterior reversible encephalopathy syndrome. Abdominal computed tomography (10 days after admission) demonstrated a thickened pancreas in connection with inflammation and two small hypodense foci in the anterior part of the pancreas body, translating small foci of necrosis. The investigation of a thrombophilic defect revealed a heterozygous G20210A prothrombin gene mutation. The patient was discharged without neurological sequelae and asymptomatic. The follow-up brain magnetic resonance imaging confirmed the reversal of the lesions, confirming the diagnosis.A síndrome de enfalopatia posterior reversível é uma síndrome neurológica caracterizada por cefaleias, confusão, alterações visuais e convulsões associada a áreas de edema cerebral identificável em exames de neuroimagem. Os autores relatam o caso de um homem, 33 anos, leucodérmico, com história de alcoolismo e tabagismo crónico, que recorre ao serviço de urgência por epigastralgia em cinturão e vómitos com cerca de seis horas de evolução e cefaleia holocraneana intensa há duas horas. Ao exame objectivo, apresentava tensão arterial de 190/100 mmHg e empastamento no epigastro. Analiticamente, amilase 193 U/L e lipase 934 U/L. Durante a observação no serviço de urgência, apresentou uma crise tónico-clónica generalizada. A ecografia abdominal realizada foi sugestiva de pancreatite, sem sinais de litíase biliar. A tomografia computorizada crânio-encefálica demonstrou hemorragia subaracnoideia e pequena hemorragia cortical frontal direita. A ressonância magnética nuclear crânio-encefálica realizada uma semana após a admissão revelou áreas de hipersinal T2/FLAIR bilaterais e simétricas na substância branca subcortical das regiões parietais e frontais superiores, sugerindo o diagnóstico de síndrome de enfalopatia posterior reversível. Na tomografia computorizada abdominal (10 dias após a admissão) visualizou-se pâncreas espessado, em relação com processo inflamatório e dois pequenos focos hipodensos na parte anterior do corpo, traduzindo pequenos focos de necrose. A investigação de defeitos trombofílicos revelou uma mutação do gene G20210A da protrombina em heterozigotia. O doente teve alta sem sequelas neurológicas, e assintomático. A ressonância magnética nuclear crânio-encefálica de controlo confirmou a reversão das lesões, confirmando o diagnóstico.Ordem dos Médicos2016-09-30info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfimage/tiffimage/tiffimage/tiffimage/jpegimage/jpegimage/jpegimage/jpegimage/jpegimage/jpegimage/jpegimage/jpegimage/jpegimage/jpeghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7368oai:ojs.www.actamedicaportuguesa.com:article/7368Acta Médica Portuguesa; Vol. 29 No. 9 (2016): September; 567-571Acta Médica Portuguesa; Vol. 29 N.º 9 (2016): Setembro; 567-5711646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7368https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7368/4768https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7368/8160https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7368/8161https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7368/8162https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7368/8248https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7368/8249https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7368/8250https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7368/8251https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7368/8252https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7368/8253https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7368/8523https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7368/8525https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7368/8526https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7368/8527Direitos de Autor (c) 2016 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessPereira, Vítor MagnoCorreia, Luís MaroteRodrigues, TiagoFaria, Gorete Serrão2022-12-20T11:05:11Zoai:ojs.www.actamedicaportuguesa.com:article/7368Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:19:26.777277Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Acute Pancreatitis and Posterior Reversible Encephalopathy Syndrome: A Case Report Pancreatite Aguda e Síndrome de Encefalopatia Posterior Reversível: Relato de um Caso |
title |
Acute Pancreatitis and Posterior Reversible Encephalopathy Syndrome: A Case Report |
spellingShingle |
Acute Pancreatitis and Posterior Reversible Encephalopathy Syndrome: A Case Report Pereira, Vítor Magno Alcoholism/complications Brain Edema Pancreatitis Alcoholic Posterior Leukoencephalopathy Syndrome. Alcoolismo/complicações Edema Cerebral Pancreatite Alcoólica Síndrome de Enfalopatia Posterior Reversível. |
title_short |
Acute Pancreatitis and Posterior Reversible Encephalopathy Syndrome: A Case Report |
title_full |
Acute Pancreatitis and Posterior Reversible Encephalopathy Syndrome: A Case Report |
title_fullStr |
Acute Pancreatitis and Posterior Reversible Encephalopathy Syndrome: A Case Report |
title_full_unstemmed |
Acute Pancreatitis and Posterior Reversible Encephalopathy Syndrome: A Case Report |
title_sort |
Acute Pancreatitis and Posterior Reversible Encephalopathy Syndrome: A Case Report |
author |
Pereira, Vítor Magno |
author_facet |
Pereira, Vítor Magno Correia, Luís Marote Rodrigues, Tiago Faria, Gorete Serrão |
author_role |
author |
author2 |
Correia, Luís Marote Rodrigues, Tiago Faria, Gorete Serrão |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Pereira, Vítor Magno Correia, Luís Marote Rodrigues, Tiago Faria, Gorete Serrão |
dc.subject.por.fl_str_mv |
Alcoholism/complications Brain Edema Pancreatitis Alcoholic Posterior Leukoencephalopathy Syndrome. Alcoolismo/complicações Edema Cerebral Pancreatite Alcoólica Síndrome de Enfalopatia Posterior Reversível. |
topic |
Alcoholism/complications Brain Edema Pancreatitis Alcoholic Posterior Leukoencephalopathy Syndrome. Alcoolismo/complicações Edema Cerebral Pancreatite Alcoólica Síndrome de Enfalopatia Posterior Reversível. |
description |
The posterior reversible encephalopathy syndrome is a neurological syndrome characterized by headache, confusion, visual disturbances and seizures associated with identifiable areas of cerebral edema on imaging studies. The authors report the case of a man, 33 years-old, leukodermic with a history of chronic alcohol and tobacco consumption, who is admitted to the emergency department for epigastric pain radiating to the back and vomiting with about six hours of evolution and an intense holocranial headache for two hours. His physical examination was remarkable for a blood pressure of 190/100 mmHg and tenderness in epigastrium. His analytical results revealed emphasis on amylase 193 U/L and lipase 934 U/L. During the observation in the emergency department,he presented a generalized tonic-clonic seizure. Abdominal ultrasonography was performed and suggestive of pancreatitis withoutgallstones signals. Head computed tomography showed subarachnoid haemorrhage and a small right frontal cortical haemorrhage. The brain magnetic resonance imaging done one week after admission showed areas of a bilateral and symmetrical T2 / FLAIR hyperintensities in the subcortical white matter of the parietal and superior frontal regions, suggesting a diagnosis of posterior reversible encephalopathy syndrome. Abdominal computed tomography (10 days after admission) demonstrated a thickened pancreas in connection with inflammation and two small hypodense foci in the anterior part of the pancreas body, translating small foci of necrosis. The investigation of a thrombophilic defect revealed a heterozygous G20210A prothrombin gene mutation. The patient was discharged without neurological sequelae and asymptomatic. The follow-up brain magnetic resonance imaging confirmed the reversal of the lesions, confirming the diagnosis. |
publishDate |
2016 |
dc.date.none.fl_str_mv |
2016-09-30 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
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article |
status_str |
publishedVersion |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7368 oai:ojs.www.actamedicaportuguesa.com:article/7368 |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7368 |
identifier_str_mv |
oai:ojs.www.actamedicaportuguesa.com:article/7368 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7368 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7368/4768 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7368/8160 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7368/8161 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7368/8162 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7368/8248 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7368/8249 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7368/8250 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7368/8251 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7368/8252 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7368/8253 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7368/8523 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7368/8525 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7368/8526 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7368/8527 |
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Direitos de Autor (c) 2016 Acta Médica Portuguesa info:eu-repo/semantics/openAccess |
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Direitos de Autor (c) 2016 Acta Médica Portuguesa |
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Ordem dos Médicos |
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Ordem dos Médicos |
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Acta Médica Portuguesa; Vol. 29 No. 9 (2016): September; 567-571 Acta Médica Portuguesa; Vol. 29 N.º 9 (2016): Setembro; 567-571 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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