Posterior reversible encephalopathy syndrome (PRES) in a patient with complicated appendicitis. A case report

Abstract

Posterior reversible encephalopathy syndrome (PRES) is clinical entity characterised by neurologic and radiologic findings. PRES is predominantly caused by malignant hypertension mostly seen in obstetric practise however it has also been associated with sepsis in females. We describe a case of a 11 years old female who presented with complicated appendicitis and developed PRES during her admission at Dr Gearge Mukhari Academic Hospital. Diagnosis: Following exploratory laparotomy for complicated appedicitis with generalized peritonitis, she developed vision loss. CT findings were in keeping with posterior reversible encephalopathy syndrome Interventions: The patient was managed expectedly for sepsis and shock. Her symptoms resolved and she regained her sight completely with no neurological deficits. Conclusions: Intra-abominal sepsis is documented risk factor for PRES through inflammatory vascular phenomonon which is poorly understood. Complicated appendicitis can be complicated with this clinical syndrome aspresented in our practise.