Central pontine myelinolysis associated with acute haemorrhagic pancreatitis.

Acute pancreatitis is not only life-threatening in itself, but can also present a wide variety of complications that increase its morbidity. Particularly challenging are the extrapancreatic manifestations of the disease, which are rarely seen. Subcutaneous nodular fat necrosis (Weber-Christian syndrome), ascites, pleural effusions, nephrosis, fat emboli, venous thromboses and fat necrosis of bone have been documented recently (Lynch, 1954; Swerdlow, Berman, Gibbel, and Valaitis, 1960; Lucas and Owens, 1962). Cerebral perivascular demyelination associated with acute haemorrhagic pancreatitis has been reported on one previous occasion (Vogel, 1951). However, other demyelinative encephalopathies have been described as a result of excessive alcohol ingestion and include the symmetrical demyelination ofthe corpus callosum described by Marchiafava and Bignami (1903), and central pontine myelinolysis recently described by Adams, Victor, and Mancall, (1959). The case to be described is that of a middle-aged alcoholic male with relapsing pancreatitis who developed diffuse symmetrical demyelination of the pons and corpus callosum.