Rothermich and Von Haam were the first to describe the pancreatic encephalopathy in 1941. The diagnosis of pancreatitis was determined by the high amylase levels in the blood and by the pathological lesions observed during the cholecystectomy. A post-mortem examination was performed in five patients, revealing diffuse areas of small bleeds and perivascular demyelization in the brains [1]. Acute pancreatitis in persons with alcohol abuse is observed in approximately 36% with a significant male predominance [2].

We present a post-mortem 7.0-tesla magnetic resonance imaging (MRI) of the brain, of a 65-year old man with chronic liver cirrhosis who developed an acute pancreatitis with associated severe neuropsychiatric symptoms leading to death. Three coronal sections of a cerebral hemisphere and a horizontal section of a cerebellar were submitted to T2 and T2* MRI sequences.

The coronal sections of the cerebral hemisphere show small patchy areas of white matter changes on the T2 sequence with in the frontal section on the T2* sequence an additional small marginal bleed. Also some cortical micro- bleeds are detected in the 3 coronal sections on the T2* sequence.

No white matter changes or cortical micro-bleeds are observed in the cerebellar section. The present study confirms the MRI findings observed in living patients with a “pure” pancreatic encephalopathy [3,4].

Acknowledgments

None.

Conflicts of interest

The author declares no conflict of interest.

1. Rothermich N, Von Haam E. Pancreatic encephalopathy. J Clin Endocrin. 1941; 1: 872-881.
2. Wang GJ, Gao CF, Wei D, Wang C, Ding SQ. Acute pancreatitis: Etiology and common pathogenesis. World J Gastroenterol. 2009; 15: 1427.
3. Boon P, De Reuck J, Achten E, De Bleecker J. Pancreatic encephalopathy. A case report and review of the literature. Clin Neurol Neurosurg. 1991; 93: 137-141.

4. De Reuck J. Pancreatic encephalopathy. Adv Clin Endo Met. 2018; 1: 7-15.