Wernicke's encephalopathy after laparoscopic sleeve gastrectomy.

Area of Science:

• Neurology
• Gastroenterology
• Nutritional Science

Background:

• Wernicke's encephalopathy (WE) is a serious neurological condition.
• Bariatric surgery, particularly malabsorptive procedures, is a known risk factor for WE.
• Sleeve gastrectomy is generally considered lower risk, but WE can still occur.

Purpose of the Study:

• To present a case of Wernicke's encephalopathy following sleeve gastrectomy.
• To highlight the importance of clinical suspicion in diagnosing WE post-sleeve gastrectomy.
• To emphasize the effectiveness of timely thiamine repletion.

Main Methods:

• Case report of a 48-year-old patient with obesity (BMI 55).
• Patient underwent sleeve gastrectomy and cholecystectomy.
• Diagnosis based on clinical presentation (vomiting, confusion, amnesia, limb weakness) and low thiamine levels.

Main Results:

• The patient presented with symptoms consistent with Wernicke's encephalopathy after surgery.
• Low blood thiamine levels confirmed the diagnosis.
• Intravenous thiamine treatment led to adequate clinical improvement.

Conclusions:

• Wernicke's encephalopathy is a potential complication of sleeve gastrectomy, irrespective of malabsorption.
• Early clinical suspicion and biochemical confirmation are vital for prompt treatment.
• Intravenous thiamine administration is effective in managing WE and preventing long-term sequelae.