Wernicke's syndrome after sleeve gastrectomy.
We report a case of Wernicke's encephalopathy after sleeve gastrectomy, which had been complicated by stomach wall edema and aggravated by dietary non-compliance. Despite intense parenteral nutrition, thiamine deficiency became clinically evident. It suggests that nutritional preparations used were unable to cover the increased thiamine requirement. After intense thiamine supplementation, gradual improvement occurred during the 6 months after the diagnosis, without permanent cognitive impairment. Clinicians involved in postoperative management of bariatric surgery patients must consider Wernicke's syndrome in hyper-emetic patients, who show unclear neurological deterioration. Early diagnosis and treatment can instantly improve the patient's condition without permanent sequelae.
Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Poland. wojmakar@wp.pl
Wojciech
W
Makarewicz
Lukasz
L
Kaska
Jarek
J
Kobiela
Tomasz
T
Stefaniak
Jacek
J
Krajewski
Marta
M
Stankiewicz
Magdalena A
MA
Wujtewicz
Andrzej J
AJ
Lachinski
Zbigniew
Z
Sledzinski
D000328:Adult; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D009767:Obesity, Morbid / Q000601:surgery*; D013832:Thiamine Deficiency / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D014899:Wernicke Encephalopathy / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy