Acute Wernicke's encephalopathy complicating chronic gallstone ileus

Area of Science:

• Neurology
• Gastroenterology
• Pathology

Background:

• Gallstone ileus is a rare complication of cholelithiasis.
• Small bowel obstruction can lead to malnutrition and vitamin deficiencies.
• Wernicke's encephalopathy is a neurological disorder caused by thiamine deficiency.

Purpose of the Study:

• To report a case of acute Wernicke's encephalopathy secondary to gallstone ileus.
• To highlight the importance of recognizing Wernicke's encephalopathy in patients with intestinal obstruction and malnutrition.

Main Methods:

• Autopsy examination of a 53-year-old male patient.
• Morphological analysis of brain tissue for signs of Wernicke's encephalopathy.
• Clinical history review focusing on gastrointestinal symptoms and nutritional status.

Main Results:

• Autopsy revealed morphological features consistent with acute Wernicke's encephalopathy.
• The patient had unrelieved small bowel obstruction due to gallstone ileus.
• Thiamine deficiency was identified as the likely cause of Wernicke's encephalopathy.

Conclusions:

• Acute Wernicke's encephalopathy can develop in patients with prolonged intestinal obstruction and subsequent malnutrition.
• Clinical suspicion and awareness are crucial for diagnosing Wernicke's encephalopathy in at-risk populations.
• Early recognition and treatment of thiamine deficiency are vital to prevent severe neurological sequelae.