title: Neurological disturbances and hyperdynamic shock in a patient with esophagocoloplasty.
abstract: A 39-year-old man, with no history of alcohol intake, who had had an esophago-ileo-colo-gastroplasty with ileotransversostomy, developed diplopia, seizures, metabolic acidosis, and cardiac failure and finally refractory hyperdynamic shock. He died 20 h after admission to our intensive care unit from cardiocirculatory collapse. Postmortem results revealed low erythrocyte transketolase activity, which was increased by 22% by in vitro addition of thiamine diphosphate (TDP effect). Cerebral pathology showed the alterations of Wernicke's encephalopathy. We discuss the possible mechanisms of fatal cardiovascular collapse and the unusual presentation of a case without a history of alcoholic intake or clinical malnutrition.
authors.affiliation: Servei de Medicina Intensiva, Hospital General, Barcelona, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Campos
authors.forename: J R
authors.initials: JR
authors.lastname: Masclans
authors.forename: A
authors.initials: A
authors.lastname: Ortega
authors.forename: C
authors.initials: C
authors.lastname: Martin
authors.forename: F J
authors.initials: FJ
authors.lastname: de Latorre
authors.forename: M
authors.initials: M
authors.lastname: Planas
mesh_terms: D000138:Acidosis / Q000209:etiology*; D000328:Adult; D004944:Esophagoplasty / Q000009:adverse effects*; D017809:Fatal Outcome; D015391:Gastroplasty / Q000009:adverse effects*; D006261:Headache / Q000209:etiology; D006801:Humans; D007081:Ileostomy / Q000009:adverse effects; D008297:Male; D012640:Seizures / Q000209:etiology; D012678:Sensation Disorders / Q000209:etiology*; D012769:Shock / Q000209:etiology*; D013695:Temperance; D013832:Thiamine Deficiency / Q000150:complications* / Q000175:diagnosis / Q000209:etiology