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CLC number: R591.42+1

On-line Access: 2010-06-02

Received: 2010-01-11

Revision Accepted: 2010-04-22

Crosschecked: 2010-05-05

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Journal of Zhejiang University SCIENCE B 2010 Vol.11 No.6 P.433-436

10.1631/jzus.B1000016


Wernicke encephalopathy following splenectomy in a patient with liver cirrhosis: a case report and review of the literature


Author(s):  Xia-ping Zhang, Yuan-qiang Lu, Wei-dong Huang

Affiliation(s):  Department of Emergency, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China

Corresponding email(s):   luyuanqiang@yahoo.cn

Key Words:  Wernicke encephalopathy, Liver cirrhosis, Thiamine, Splenectomy


Xia-ping Zhang, Yuan-qiang Lu, Wei-dong Huang. Wernicke encephalopathy following splenectomy in a patient with liver cirrhosis: a case report and review of the literature[J]. Journal of Zhejiang University Science B, 2010, 11(6): 433-436.

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author="Xia-ping Zhang, Yuan-qiang Lu, Wei-dong Huang",
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doi="10.1631/jzus.B1000016"
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%T Wernicke encephalopathy following splenectomy in a patient with liver cirrhosis: a case report and review of the literature
%A Xia-ping Zhang
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%A Wei-dong Huang
%J Journal of Zhejiang University SCIENCE B
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%P 433-436
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%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B1000016

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T1 - Wernicke encephalopathy following splenectomy in a patient with liver cirrhosis: a case report and review of the literature
A1 - Xia-ping Zhang
A1 - Yuan-qiang Lu
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SP - 433
EP - 436
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PB - Zhejiang University Press & Springer
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DOI - 10.1631/jzus.B1000016


Abstract: 
Objective: To report a case of wernicke encephalopathy in the early stage after surgery. Methods: A nonalcoholic female patient with hepatitis B-related cirrhosis and hypersplenism underwent splenectomy in a local hospital. No surgical complications occurred and the patient recovered well. However, on the eighth postoperative day she developed psychiatric and neurological disturbance without an obvious cause. She was then admitted to our hospital. Brain magnetic resonance imaging (MRI) with FLAIR T2 showed symmetric high-signal intensities in the periaqueductal area of the midbrain, which were consistent with wernicke encephalopathy. She was thus given intramuscular thiamine immediately. Results: After the administration of thiamine, the patient’s confused mental state resolved within 3 d, and her dystaxia gradually improved over the next 5 d. The brain MRI with FLAIR T2 was re-examined one month after the episode, and showed nearly complete resolution of the previously abnormal signal intensities in the periaqueductal area of the midbrain. Conclusion: Physicians should be aware of the possibility of acute wernicke encephalopathy, especially in patients with liver dysfunction.

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

Reference

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