• Xin Zhong and Shu Gong.
• Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
• Medicine (Baltimore). 2017 Dec 1; 96 (50): e8984.

RationalePancreatic encephalopathy (PE) refers to the abnormalities in mental status that complicate acute pancreatitis (AP). We report the case of a patient who developed AP that was complicated by PE and followed by fatal cerebral hemorrhage.Patient ConcernsA 41-year-old male patient with AP that initially manifested with PE and was subsequently complicated by fatal cerebral hemorrhage.DiagnosesA head computed tomography (CT) scan showed a fatal intracerebral hemorrhage located in the occipital lobe, and an abdominal CT scan presented a large amount of peripancreatic fluid collections.InterventionsThe patient received a hematoma evacuation. The volume of the hematoma was approximately 15 mL. A consequent open pancreatic necrosectomy was performed to remove all necrotic tissues and to drain the peripancreatic fluid collections.OutcomesThe patient could perform his normal daily activities efficiently, and no abnormality was observed in the physical examination 3 months after his discharge.LessonsAlthough uncommon, PE should be properly monitored. Once the neurological symptoms of a patient dramatically worsen within a short time, the possibility of fatal cerebral hemorrhage should be considered.Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

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