title: Lactic acidosis from thiamine deficiency during parenteral nutrition in a two-year-old boy.
abstract: This is a case report of a two-year-old boy who was operated electively for a blind-loop syndrome of the proximal jejunum. Because of the appearance of chylous ascites, parenteral nutrition was carried out postoperatively. The boy developed a severe uncompensated acidosis and paralytic ileus. Relaparotomy on suspicion of ischemic bowel did not explain the cause of the acidosis and ileus. Postoperatively, the child's condition worsened, requiring intensive care. The drastically elevated lactate levels corroborated the eventually suspected diagnosis of a vitamin B1 deficiency syndrome. The administration of thiamine within two hours produced correction of the acidosis without further bicarbonate therapy. In 24 hours circulation was stabilized. Two months post-operatively the boy had completely recovered from the sequelae of his shock event.
authors.affiliation: General Surgery Department, Essen University Clinic, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Lange
authors.forename: J
authors.initials: J
authors.lastname: Erhard
authors.forename: F W
authors.initials: FW
authors.lastname: Eigler
authors.forename: C
authors.initials: C
authors.lastname: Roll
mesh_terms: D000140:Acidosis, Lactic / Q000209:etiology* / Q000628:therapy; D002675:Child, Preschool; D006801:Humans; D007409:Intestinal Atresia / Q000473:pathology / Q000601:surgery*; D007583:Jejunum / Q000002:abnormalities* / Q000473:pathology / Q000601:surgery; D007773:Lactates / Q000097:blood; D019344:Lactic Acid; D008297:Male; D010289:Parenteral Nutrition, Total; D011183:Postoperative Complications / Q000209:etiology* / Q000628:therapy; D012086:Reoperation; D013832:Thiamine Deficiency / Q000209:etiology* / Q000628:therapy; D014803:Vitamin B Complex / Q000008:administration & dosage
chemical_list: D007773:Lactates; D014803:Vitamin B Complex; D019344:Lactic Acid