[A new treatment: bariatric surgery; a new complication: Wernicke-Korsakoff encephalopathy].
BACKGROUND
Bariatric surgery has peripheral or central neurological complications in 5-10% of patients.


METHODS
We report the case of a 39-year-old man with metabolic syndrome who underwent gastric by-pass surgery and then lost 40 kg over a period of 2.5 months. He subsequently developed symptoms suggestive of Wernicke-Korsakoff encephalopathy, secondary to stenosis of the gastrojejunal anastomosis, which led to repeated unreported vomiting.


CONCLUSIONS
This neurological syndrome, linked to thiamine deficiency, can be found with insufficient nutrition after surgery or severe vomiting after bariatric surgery. The complications are essentially peripheral neuropathy and metabolic dysfunctions, including iron and vitamin (B12, D, folate) deficiencies. This case reminds us that bariatric surgery requires close metabolic follow-up with periodic assays of vitamin levels, including thiamine, even when supplementation was prescribed.
Morel
Laurent
L
Clinique de médecine interne et Clinique de chirurgie, Hôpital Cantonal de Fribourg, CH-1700 Fribourg, Suisse.
Fontana
Enzo
E
Michel
Jean-Marie
JM
Ruffieux
André
A
Ottiger
Murielle
M
Regamey
Claude
C
D000328:Adult; D050110:Bariatric Surgery / Q000009:adverse effects*; D006801:Humans; D020915:Korsakoff Syndrome / Q000209:etiology*; D008297:Male