Beriberi, a severe complication after metabolic surgery – review of the literature Full Text
Obesity Facts, 10/07/2014 Review Article Clinical Article
Stroh C, et al. – The epidemic growth of morbid obesity has led to an increase in the number of bariatric interventions. During the distribution process of bariatric surgical interventions, the risk for severe nutritious complications such as bariatric beriberi can rise. Bariatric beriberi can occur within the first 1–3 postoperative months. Immediate substitution of thiamine in clinical suspicion or prolonged parenteral nutrition is necessary to minimize the risk of severe consequences. A delayed or missed diagnosis can lead to irreversible damage of the CNS, with coma and fatal outcome.
Methods
By means of a systematic literature review, epidemiological data, clinical characteristics, and diagnostic as well as therapeutic recommendations for bariatric beriberi were elicited.
Databases and registries such as PubMed, Cochrane, and Ovid were searched for a defined time period with the key words "lack of thiamine" / "Wernicke–Korsakoff syndrome" / "encephalopathy" after bariatric surgical interventions.
Results
Up to December 2013, overall 255 patients had been found as published cases, indicating that the risk for the postoperative occurrence of thiamine deficiency and Wernicke–Korsakoff syndrome is increased in women.
In addition, the risk correlates with patients' age.
The majority of patients developed symptoms of a dry beriberi with peripheral neuritis, ataxia, and paraplegia, indicating an advanced stage of disease approximately 4–12 weeks postoperatively.
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