[Beriberi after esophagectomy].

Area of Science:

• Anesthesiology
• Neurology
• Nutritional Science

Background:

• Esophageal cancer treatment often involves chemotherapy and surgery.
• Patients with poor nutritional status are at risk for complications.
• Parenteral nutrition, if not properly supplemented, can lead to deficiencies.

Observation:

• A patient with esophageal cancer developed hypotension and metabolic acidosis during surgery.
• Postoperatively, the patient exhibited severe neurological deficits including disorientation, aphasia, and ophthalmoplegia.
• These symptoms were unresponsive to standard hemodynamic support.

Findings:

• The patient was diagnosed with Wernicke's encephalopathy, a neurological condition caused by thiamine (vitamin B1) deficiency.
• The neurological symptoms and metabolic disturbances resolved favorably after thiamine administration.
• This case highlights the potential for beriberi in hospitalized patients, particularly those receiving inadequate parenteral nutrition.

Implications:

• Anesthesiologists must be vigilant for Wernicke's encephalopathy in at-risk patients undergoing surgery.
• Prompt thiamine (vitamin B1) supplementation is crucial for preventing severe neurological sequelae.
• Ensuring adequate vitamin and mineral content in parenteral nutrition formulas is essential for surgical patients.