Peripheral Neuropathy due to Vitamin B₁ Deficiency Developed 6 Months after Pylorus-preserving Total Gastrectomy: Report of a Case

Kazuhiro Iwase¹⁾, Jun Higaki¹⁾, Shoki Mikata¹⁾, Yasushi Tanaka¹⁾, Masato Yoshikawa¹⁾, Tomono Kishimoto¹⁾, Kei Torikai¹⁾, Keiko Toyooka²⁾, Takeyoshi Yumiba³⁾ and Wataru Kamiike¹⁾

Department of Surgery, Rinku General Medical Center, Izumisano Municipal Hospial¹⁾
Department of Neurology, Rinku General Medical Center, Izumisano Municipal Hospital²⁾
Division of General and Gastroenterological Surgery, Department of Surgery,
Osaka University Graduate School of Medicine³⁾

A case of peripheral neuropathy due to vitamin B₁ deficiency developed 6 months after pylorus-preserving subtotal gastrectomy is reported. Pylorus-preserving total gastrectomy and reconstruction by jejunal pouch interposition with fundoplication was performed for gastric cancer in a 32-yera-old man. He had a balanced diet and no alcohol postoperatively. Abdominal computed tomography 3 months after operation revealed marked dilatation of the interposed jejunum. The quantity of daily oral intake had been sufficient since 4 months after operation; however, the patient complained of dysesthesia and muscle weakness in the distal parts of the lower extremities 6 months after operation. The sensory action potential of the sural nerve was not evoked during electrophysiologic examination. The blood level of vitamin B₁was decreased as 11 ng/ml (normal range: 20-50). Symptoms gradually improved following vitamin B₁ administration. Caution should be paid to the possibility of vitamin B₁ deficiency in cases with passage disorder of the upper alimentary tract following gastrectomy.

Key words
Vitamin B₁, neuropathy, gastrectomy

Reprint requests
Kazuhiro Iwase Department of Surgery, Rinku General Medical Center, Izumisano Municipal Hospital, 2-23 Rinkuohrai-kita, Izumisano, 598-8577 JAPAN

Accepted
September 22, 1999

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