Volume 64 - 2001 - Fasc.2 - Case reports
Autoimmune pancreatitis mimicking cancer of the head of pancreas Report of two cases
Autoimmune pancreatitis has been characterised in 1995, but only a few cases have been published since then, most of them from Japan. This report describes the cases of two Belgian male patients who presented with isolated obstructive jaundice. Radiological imaging studies were highly suggestive of carcinoma of the head of pancreas and both patients underwent uneventful cephalic pancreaticoduodenectomy with portal vein resection. Pathological analysis of the removed tissues suggested an autoimmune process in both cases. Both patients had hyper-gammaglobutinemia and antinuclear antibodies, but failed to show evidence of any other autoimmune disease or cause of chronic pancreatitis. In both cases final diagnosis was autoimmune pancreatitis. Preoperative clinical suspicion of this diagnosis is mandatory and may avoid unnecessary surgery in future cases.
Hepatic myelopathy after splenorenal shunting: report of one case and review of the literature
Hepatic myelopathy is a rare complication of cirrhosis, usually associated with surgical or spontaneous porto-systemic shunts. Its pathophysiology is unknown. It is characterized by a motor involvement of the lower limbs without clinical sensory abnormality, leading to spastic paraparesis. These neurological features are related to a symmetric loss of myelin in the lateral corticospinal tracts. Usefulness of liver transplantation in this setting is not yet determined. We describe here the case of a 29-year-old male who presented with progressive spastic paraparesis of the lower limbs 3 years after a spleno-renal shunt.
