Wernicke encephalopathy--a debilitating acute or subacute
neurological disorder-is caused by a deficiency in
thiamine (
vitamin B(1)). It is characterized by a classical clinical triad of symptoms: ocular impairment,
cerebellar dysfunction, and
confusion. Although
bariatric surgery can certainly improve the overall health of an obese individual, it can also make him or her more susceptible to serious nutrition deficiencies. Following surgery, inadequate caloric intake, rapid and excessive
weight loss,
food intolerance, lack of adherence to nutrition supplementation, and/or the onset of prolonged
vomiting can lead to severe nutrition deficiencies. It is generally believed that the more malabsorptive the surgery proves, the more likely is it that such a deficiency will occur. The case presented here shows that after sleeve
gastrectomy (SG), a patient may also develop dangerous nutrition deficits that can negatively affect his or her life. In this particular case, a patient presented with a severe
vitamin B(1) deficiency following SG for
morbid obesity. Although patients may exhibit pathophysiologies similar to
Wernicke encephalopathy after this surgery, only 2 cases of severe
vitamin B(1) deficiency following sleeve
gastrectomy have been reported. The grave consequences of
thiamine deficiency observed in this patient underscore the importance of supplementation after SG.