Slim Skander, Ayed Karim, Triki Wissem, Baccar Abdelmajid, Baraket Oussama, Rahal Khaled, Ganzoui Imen, Bouchoucha Sami
Surgical Oncology Department, Salah Azaiez Institute of Cancer, Tunis, Tunisia.
Surgical Department, Habib Bougatfa Hospital, Bizerta, Tunisia.
BMC Nutr. 2022 Aug 17;8(1):83. doi: 10.1186/s40795-022-00585-w.
Gayet-Wernicke's encephalopathy (GWE) is a neurological pathology caused by a Thiamine deficiency. While it is most often related to chronic alcoholism, GWE can occur in any situation that results in thiamine deficiency. It is a fairly common pathology that is frequently underdiagnosed and therefore under-treated, and is associated with a high mortality and morbidity rate. In the absence of pathognomonic signs, the diagnosis of GWE relies on a range of clinical, biological and radiological assessments. GWE is considered a medical emergency. We present a case of Gayet-Wernicke's Encephalopathy resulting from complete parenteral nutrition in an undernourished North African male operated for a left colon tumor. Through this report, our aim was to put the light on this often underknown disease and to remind the interest of thinking about this pathology in patients at risk of undernourishment especially in oncology.
A 66-year-old North African male with no personal or family history was operated for a sigmoid colon tumor. He was put on exclusive parenteral nutrition on day thirteen post-operatively and presented with a GWE on day sixteen post-operatively. The patient was treated with intravenous vitamin B1 on day eighteen post-operatively and deceased on day twenty-four post-operatively.
Although most often associated with chronic alcoholism, GWE occurs in any situation where there is an increased energy demand or decreased nutritional intake especially in oncology. GWE is common but under-diagnosed and remains lethal if not treated urgently, hence the importance of prophylactic treatment.
盖耶 - 韦尼克脑病（GWE）是一种由硫胺素缺乏引起的神经病理学疾病。虽然它最常与慢性酒精中毒有关，但GWE可发生在任何导致硫胺素缺乏的情况下。它是一种相当常见的病理学疾病，经常被漏诊，因此治疗不足，并且与高死亡率和发病率相关。在没有特征性体征的情况下，GWE的诊断依赖于一系列临床、生物学和放射学评估。GWE被视为医疗紧急情况。我们报告一例因完全肠外营养导致的盖耶 - 韦尼克脑病，患者为一名营养不良的北非男性，因左结肠肿瘤接受手术。通过本报告，我们的目的是关注这种常不为人知的疾病，并提醒人们关注在有营养不良风险的患者中，尤其是肿瘤患者中考虑这种病理学疾病的重要性。
一名66岁的北非男性，无个人或家族病史因乙状结肠肿瘤接受手术。术后第13天开始接受全胃肠外营养，术后第16天出现GWE。患者在术后第18天接受静脉注射维生素B1治疗，术后第24天死亡。
虽然GWE最常与慢性酒精中毒相关，但它发生在任何能量需求增加或营养摄入减少的情况下，尤其是在肿瘤学领域。GWE很常见但易被漏诊，如果不紧急治疗仍然致命，因此预防性治疗很重要。
