Pancreatic encephalopathy in 24 patients with severe acute pancreatitis.
BACKGROUND
Pancreatic encephalopathy (PE), an unfamiliar complication of severe acute pancreatitis (SAP), is difficult to diagnose and treat, and it has a high mortality. The aim of this study was to investigate the manifestation, classification, mechanism and therapy of PE.


METHODS
Of 132 patients with SAP treated at our hospital from March 1994 to March 2004, 24 patients complicated by PE were analyzed retrospectively.


RESULTS
The causes of SAP were mostly biliary and alcoholic. Twenty-four patients (18.2%) were complicated by PE within 3 hours-38 days(average 6.6 days)[21(87.5%) within 2 weeks, and 3(12.5%) after 2 weeks] . Eleven patients were male and 13 female, with an average of 47 years (range 25-72 years). Excitement or restrain was the main manifestation. Nine patients (37.5%) received surgery and 15(62.5%) conservative treatment, with a mortality of 11.1%(1/9) and 66.7%(10/15), respectively.


CONCLUSIONS
PE occurs 2 weeks after SAP and is part of multiple organ failure (MOF). Some patients have PE in the late stage of SAP because of lack of VitB1 and nutrition. But PE can be prevented by prescribing adequate nutrition and VitB1 in the early stage of SAP.
Ding
Xiong
X
Department of Hepatobiliary Surgery, Second Clinical College, Chongqing University of Medical Sciences, Chongqing 400010, China. dingpanda@163.com
Liu
Chang-An
CA
Gong
Jian-Ping
JP
Li
Sheng-Wei
SW
D000208:Acute Disease; D000328:Adult; D000368:Aged; D001927:Brain Diseases / Q000188:drug therapy / Q000209:etiology* / Q000401:mortality; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications* / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013831:Thiamine / Q000627:therapeutic use
D013831:Thiamine