Abstract
We report a case of lactic acidosis after total gastrectomy which appeared to be due to peripheral parenteral nutrition, and was successfully treated with vitamin B1 (thiamine).
A 79-year-old-man, undergone total gastrectomy three months earlier, presented with abdominal pain and abdominal fullness. He was diagnosed as having strangulation ileus and peritonitis and underwent emergency surgery. Although the necrotic portion of the small intestine was excised, acidosis was prolonged, and on the day after the operation, dyspnea developed. The blood lactate level was high, 8.1nmol/l, and we diagnosed the case as lactic acidosis. Vitamin B1 (thiamine) was administered, and the metabolic acidosis and the blood lactate level were subsequently normalized.
Lactic acidosis due to vitamin B1 deficiency generally develops during total parenteral nutrition. In this case, latent vitamin B1 deficiency after total gastrectomy appeared to have incurred lactic acidosis due to peripheral parenteral nutrition.
