DEVELOPMENT OF WERNICKE-KORSAKOFF-SYNDROME AFTER LONG INTERVALS FOLLOWING GASTRECTOMY

Background: Surgical exclusion of portions of the gastrointestinal tra ct is a predisposing risk factor for the development of Wernicke-Korsa koff syndrome. When this disease occurs, it is usually within weeks af ter the gastrointestinal surgery. However, it is not well known that W ernicke-Korsakoff syndrome may occur after a long latent interval foll owing gastrectomy. Setting: A research-oriented hospital. Patients: Th ree patients without a history of alcoholism or dietary deprivation de veloped Wernicke-Korsakoff syndrome 2 to 20 years after undergoing gas trectomy. In these patients, minor changes in dietary habit led to the development of Wernicke-Korsakoff syndrome. Conclusions: In addition to a long-standing latent deficiency in thiamin levels due to defectiv e absorption following gastrectomy or gastrojejunostomy, other minor f actors that may influence the intake of thiamin and the need for thiam in in subjects who have undergone gastrectomy may cause a state of thi amin deficiency resulting in Wernicke-Korsakoff syndrome. Results from our study indicate that the following measures are mandatory: educati ng patients about proper dietary habits, carefully monitoring their th iamin intake, recognizing Wernicke-Korsakoff syndrome early, and treat ing it immediately with appropriate measures.