Total parenteral nutrition induced Wernicke’s encephalopathy after oncological gastrointestinal surgery
TOTAL PARENTERAL NUTRITION INDUCED WERNICKE’S ENCEPHALOPATHY AFTER ONCOLOGICAL GASTROINTESTINAL SURGERY
Carl Wernicke described the disease bearing his
name in 1881 and reported three cases characterized by the
presence of mental confusion, ataxia, and ophthalmoplegia.
Wernicke’s disease is mainly observed in alcoholic patients,
due to decreased vitamin intake as a consequence of an
unbalanced diet, and a reduction of absorption due to the
effects of alcohol. Likewise, inadequate vitamin intake is
prevalent in older patients. Wernicke’s encephalopathy due
to inappropriate total parenteral nutrition (TPN) occurs
infrequently; recently, there is an increase in the literature
concerning Wernicke’s encephalopathy in patients after
general and bariatric surgeries. We present two cases of
Wernicke’s encephalopathy after oncologic gastrointestinal
surgery by failure to administer vitamin B1 during TPN; to
our knowledge, these are the first two cases of Wernicke’s
encephalopathy after colorectal surgery for cancer. In our
opinion, timely diagnosis and treatment are mandatory to
avoid nonfunctional recovery and consequent malpractice
legal actions as well as an increase in the health-care costs.