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.
Vitamin B1, neuropathy, gastrectomy
Jpn J Gastroenterol Surg 33: 191-195, 2000
Kazuhiro Iwase Department of Surgery, Rinku General Medical Center, Izumisano Municipal Hospital, 2-23 Rinkuohrai-kita, Izumisano, 598-8577 JAPAN
September 22, 1999
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