Wernicke encephalopathy following splenectomy in a patient with liver cirrhosis: a case report and review of the literature.
OBJECTIVE
To report a case of Wernicke encephalopathy in the early stage after surgery.


METHODS
A nonalcoholic female patient with hepatitis B-related cirrhosis and hypersplenism underwent splenectomy in a local hospital. No surgical complications occurred and the patient recovered well. However, on the eighth postoperative day she developed psychiatric and neurological disturbance without an obvious cause. She was then admitted to our hospital. Brain magnetic resonance imaging (MRI) with FLAIR T2 showed symmetric high-signal intensities in the periaqueductal area of the midbrain, which were consistent with Wernicke encephalopathy. She was thus given intramuscular thiamine immediately.


RESULTS
After the administration of thiamine, the patient's confused mental state resolved within 3 d, and her dystaxia gradually improved over the next 5 d. The brain MRI with FLAIR T2 was re-examined one month after the episode, and showed nearly complete resolution of the previously abnormal signal intensities in the periaqueductal area of the midbrain.


CONCLUSIONS
Physicians should be aware of the possibility of acute Wernicke encephalopathy, especially in patients with liver dysfunction.
Zhang
Xia-ping
XP
Department of Emergency, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.
Lu
Yuan-qiang
YQ
Huang
Wei-dong
WD
D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000601:surgery*; D008875:Middle Aged; D013156:Splenectomy / Q000009:adverse effects*; D014899:Wernicke Encephalopathy / Q000175:diagnosis* / Q000209:etiology* / Q000517:prevention & control