Encéphalopathie de Gayet-Wernicke après sleeve gastrectomie pour obésité morbide

Introduction

Bariatric restrictive interventions, as sleeve gastrectomy or gastric banding can cause metabolic complications, especially when vomiting is present, such as thiamine deficiency that can lead to Wernicke's encephalopathy.

Case report

A 31-year-old man with a 47 kg/m² body mass index presented with Wernicke's encephalopathy, with ophtalmoplegia, nystagmus, ataxia and confusion, followed by a Korsakoff syndrome, occurring two months after a sleeve gastrectomy. MRI showed hyperintense signals on T2 and FLAIR image in both thalamus, periaqueducal area and mamillary bodies.

Conclusion

A close clinical and biological monitoring is required in the first year after surgery, especially if vomiting occurs. Early diagnostic and treatment are needed to avoid severe sequelae.