Manganese deposition in basal ganglia due to perioperative parenteral nutrition following gastrointestinal surgeries.
OBJECTIVE
Serial changes in blood manganese (Mn) levels and brain MRI examinations following perioperative parenteral nutrition (PN) were investigated.


METHODS
Six cases undergoing pancreatoduodenectomy (PD), 4 cases undergoing thoracic esophagectomy (TE), 18 cases undergoing total gastrectomy (TG) and 20 cases undergoing colorectal surgeries (CR) with daily administration of 20 micromol of Mn per day were studied. Cases undergoing PD, TE, TG or CR without Mn administration served as controls.


RESULTS
Hyperintense lesions in the basal ganglia on T1-weighted MRI and elevated blood Mn levels were recognized after PN in 4 of 6 cases in the PD group, in 3 of 4 cases in the TE group, in 1 of 18 cases in the TG group and in 2 of 20 cases in the CR group. No abnormalities were recognized in the control groups.


CONCLUSIONS
The possible Mn deposition in the basal ganglia caused by perioperative PN should be especially noted in cases undergoing PD or TE.
Department of Surgery, Rinku General Medical Center, Izumisano Municipal Hospital, Osaka, Japan. k-iwase@rgmc.izumisano.osaka.jp
Kazuhiro
K
Iwase
Jun
J
Higaki
Shoki
S
Mikata
Yasushi
Y
Tanaka
Haruhiko
H
Kondoh
Masato
M
Yoshikawa
Shinichi
S
Hori
Wataru
W
Kamiike
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001479:Basal Ganglia / Q000737:chemistry*; D013505:Digestive System Surgical Procedures; D016629:Esophagectomy; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008345:Manganese / Q000032:analysis* / Q000097:blood; D008875:Middle Aged; D016577:Pancreaticoduodenectomy; D010288:Parenteral Nutrition / Q000009:adverse effects*
D008345:Manganese