11. tbl. 102. árg. 2016
Beriberi 10 years after gastric bypass surgery - case report
Beriberi is primarily related to malnutrition, but
also known as a complication following abdominal surgical procedures. A 41 year
old woman, who underwent gastric bypass surgery 10 years earlier, presented at
the emergency department of Landspitali with general weakness and paresthesia.
Physical examination revealed muscle atrophy and attenuated deep tendon
reflexes in her lower limbs; presenting as polyneuropathy due to beriberi. The
diagnosis was confirmed with serum thiamine levels measuring well below reference
levels. She was treated with 300 mg of thiamine intravenously and her condition
started to improve. Thiamine deficiency in this case is most likely related to
malnutrition secondary to the gastric bypass surgery. This rare complication
must be considered in patients that present with polyneuropathy following
bariatric surgery.
Figure 1. Schematic view of the gastro-jejunal bypass. The part of the stomach receiving food has been reduced to about 50 ml and the jejunum connected with a Roux-en-Y anastomosis to the stomach, bypassing about 2 meters of small intestine. Figure: Guðjón Örn Lárusson.