Clinical analysis of 10 patients with Wernicke encephalopathy after major abdominal surgery / 中华胃肠外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To explore the pathogenesis, clinical features, diagnosis and treatment of Wernicke encephalopathy after major abdominal surgery.</p><p><b>METHODS</b>Clinical data of 10 patients with Wernicke encephalopathy after major abdominal surgery in the Zhejiang Provincial People's Hospital from 2000 to 2012 were retrospectively analyzed.</p><p><b>RESULTS</b>Wernicke encephalopathy occurred during 5 to 36 days (mean 22.9 days) after surgery. The main symptoms included vertigo, vagueness, blurred vision, and gait incoordination. MRI showed bilaterally symmetrical enhancement of T1 and T2 signal in thalamus, third ventricle, lateral ventricle and periaqueductal region. With treatment of vitamin B1, 6 patients were completely recovered, and 2 partly recovered, but 2 died.</p><p><b>CONCLUSIONS</b>Surgeons should be aware of Wernicke encephalopathy when treating patients undergoing major abdominal operation who need prolonged fasting postoperatively. Early detection and timely supplement of vitamin B1 can avoid irreversible brain damage.</p>