A Case Report of Vitamin B₁ Deficiency Showing Severe Clinical State That Occurred During Total Parenteral Nutrition after Jejunal Cancer Procedure

Masayuki Muramoto, Shizuo Usami*, Takashi Okubo**, Akira Satake*, Keiji Matsugaki, Kenji Ogino, Akio Inukai, Tadao Manabe***

Department of Surgery, Inabe Kosei Hospital
*Department of Surgery, Kariya General Hospital
**Department of Surgery, NTT Tokai General Hospital
***First Department of Surgery, Nagoya City University

We experienced a case of marked metabolic acidosis as a severe clinical state during total parenteral nutrition after jejunal cancer procedure. Vitamin B₁ deficiency seemed to be the cause of the acidosis because a bolus injection of vitamin B₁ improved the clinical condition of the patient with prompt improvement in the base excess. Overconsumption of vitamin B₁ by intravenous carbohydrates is considered tq be the mechanism of metabolic acidosis during total parenteral nutrition. Most case reports revealed latent vitamin B₁ deficiency conditions such as malignant disease, chemotherapy or irradiation in addition to no administration of vitamins. We concluded that supplementation of vitamin B₁ should be recommended during TPN after surgery.

Key words
vitamin B₁, metabolic acidosis, jejunal cancer

Reprint requests
Masayuki Muramoto Department of Surgery, Inabe Kosei Hospital
751 Ageki, Hokusei-cho, Inabe-gun, Mie, 511-04 JAPAN

Accepted
February 14, 1996

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