[Role of MRI in the diagnostic of Gayet Wernicke's encephalopathy (GWE) after gastrectomy and parenteral nutrition].
GWE is rarely described after gastric surgery following parenteral nutrition. The case of a 33 years old female with no previous alcohol addiction, who presented severe neurological disorders after reoperation for postoperative peritonitis and total parenteral nutrition is reported. She was operated 8 days before for gastric leiomyoma and underwent partial gastrectomy. The management has consisted of a tracheal intubation and welfare ventilation. The brain CT scan was normal and the brain MRI made the diagnostic of Gayet Wernicke's encephalopathy with typical signs. An inner, bilateral and symetrical on both sides of the 3rd ventricle, thalamic hypersignal. After treatment in ICU including mechanical ventilatory support and thiamine infusion, she recovered with minor neurological sequelae concicting in amnesia and false recognition. The control of MRI after 5 weeks returned to normal. Mandatory of thiamine to parenteral nutrition is recommended.
Beye
M D
MD
Service d'Anesthésie Réanimation Polyvalente Hôpital Le Dantec de Dakar. mamadoubeye@yahoo.fr
Calton
B
B
Launoy
A
A
Pottecher
T
T
Sall
Ka B
KB
D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D008279:Magnetic Resonance Imaging; D010288:Parenteral Nutrition; D010538:Peritonitis / Q000601:surgery; D012086:Reoperation; D013831:Thiamine / Q000627:therapeutic use; D013832:Thiamine Deficiency / Q000150:complications; D016896:Treatment Outcome; D014899:Wernicke Encephalopathy / Q000473:pathology*
D013831:Thiamine