2013 年 59 巻 2 号 p. 194-198
Wernicke encephalopathy (WE) is an acute neuropsychiatric syndrome resulting from thiamine (vitamin B1) deficiency. Here, we report two elderly patients who developed WE long after gastric surgery. Patient 1 was an 85-year-old man, who developed ophthalmoparesis, gait ataxia, and areflexia 43 years after distal gastrectomy (Billroth's operation I) for gastric ulcer. Patient 2 was a 78-year-old man presenting with drowsiness, ophthalmoplegia, and ataxia, 7 years after proximal gastrectomy and jejunal interposition for gastric cancer. After intravenous infusion of thiamine, patient 1 completely recovered and patient 2 partially improved. Physicians should recognize that gastric surgery is a risk factor for developing WE, and that early diagnosis and treatment are necessary.
