title: [Laparoscopic Gastrostomy for a Patient with Wernicke's Encephalopathy after Gastrectomy--A Case Report with a Literature Review].
abstract: Wernicke's encephalopathy is usually related to alcoholism, malnutrition, or hyperemesis gravidarum. We report a case of Wernicke's encephalopathy after distal gastrectomy for gastric cancer. A 58-year-old man underwent distal gastrectomy with Billroth Ⅰreconstruction for early gastric cancer. Nine months later, he developed anorexia and vomiting for a few days. Brain MRI showed no significant findings, and he resumed ingestion 5 days after admission. On the 8th day of hospitalization, dysphagia suddenly developed and brain MRI indicated Wernicke's encephalopathy. Vitamin B1 was immediately injected, and neurological symptoms gradually improved. However, dysphagia did not adequately improve, leading to severe aspiration pneumonitis. Laparoscopic gastrostomy was performed for aspiration of the stomach contents and initiation of enteral nutrition. After gastrostomy, the patient made good progress and was transferred to a rehabilitation hospital. We should recognize that gastrectomy can cause Wernicke's encephalopathy.
authors.affiliation: Division of Digestive Surgery, Dept. of Surgery, Kyoto Prefectural University of Medicine.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Arita
authors.forename: Shuhei
authors.initials: S
authors.lastname: Komatsu
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Kosuga
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Konishi
authors.forename: Ryo
authors.initials: R
authors.lastname: Morimura
authors.forename: Yasutoshi
authors.initials: Y
authors.lastname: Murayama
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kuriu
authors.forename: Atsushi
authors.initials: A
authors.lastname: Shiozaki
authors.forename: Hisashi
authors.initials: H
authors.lastname: Ikoma
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Nakanishi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ichikawa
authors.forename: Kazuma
authors.initials: K
authors.lastname: Okamoto
authors.forename: Eigo
authors.initials: E
authors.lastname: Otsuji
mesh_terms: D005743:Gastrectomy; D005774:Gastrostomy / Q000009:adverse effects*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms; D016896:Treatment Outcome; D014899:Wernicke Encephalopathy / Q000209:etiology / Q000601:surgery*