Wernicke Encephalopathy After Billroth’s II Operation: A Case Report

Introduction: Thiamine deficiency can happen after gastrectomydue to Small intestinal bacterial overgrowth (SIBO) thatleads to Wernicke encephalopathy; it is characterized bythe triad- ophthalmoplegia, ataxia and confusion. Case Presentation: A 52 year old male patient presented with confusion, diplopia, amnesia and ataxia to theRazihospital at Birjandin Iran. Cranial nerves and neurological examinations were normal. MRI, LP and abdominal sonography were also normal. Due to normal para-clinic procedure and symptom progression being observed, the patient was treated with oral and IV vitamin B1. After 3 days of treatment the patient’s condition improved and after one week he made a complete recoverywith no complaints of confusion, diplopia, ataxiaoramnesia. Conclusions: In patients with a history of surgery and mental status changes, ataxia and ophthalmoplegia should be considered from the outset of treatment because certain irreversible neurological complaints could arise due to Korsakoff syndrome.