Sadeghi Amir, Bakhshandeh Moghadam Isa, Hekmatdoost Azita, Salehi Niloufar, Zali Mohammad Reza
Gastroenterology and Liver Disease Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Neurology, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Gastroenterol Hepatol Bed Bench. 2022 Spring;15(2):179-183.
Posterior reversible encephalopathy syndrome (PRES) is a neurological disorder that occurs following cerebral vasogenic edema. It has diverse clinical presentations from headache and vomiting to seizure and mental status alteration. Herein, we report a 54-year-old woman with no prior disease who developed PRES in the parieto-occipital lobes and brain stem after a second attempt endoscopic retrograde cholangiopancreatography (ERCP). To our knowledge, no case of PRES during ERCP has been reported to date. This case reminds us of unusual complications that are likely to occur after ERCP. It is believed that blood pressure fluctuations and anesthetic medications, fentanyl in particular, were the main precipitating factors causing the syndrome in the current case. Even if there is no specific treatment for this condition, a diagnosis is critical to start supportive treatment.
后部可逆性脑病综合征（PRES）是一种继发于脑血管源性水肿的神经系统疾病。其临床表现多样，从头痛、呕吐到癫痫发作和精神状态改变。在此，我们报告一名54岁无既往病史的女性，在第二次尝试进行内镜逆行胰胆管造影（ERCP）后，在顶枕叶和脑干发生了PRES。据我们所知，迄今为止尚无ERCP期间发生PRES的病例报告。该病例提醒我们ERCP后可能会出现不寻常的并发症。据信血压波动和麻醉药物，尤其是芬太尼，是导致本例患者出现该综合征的主要诱发因素。即使对于这种情况没有特效治疗方法，但进行诊断对于启动支持性治疗至关重要。
