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Journal of Parenteral and Enteral Nutrition
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Case Reports

Wernicke's Encephalopathy After Laparoscopic Cardiomyotomy for Achalasia

R. Kennedy, MRCSI*, S. Hunt, MRCP{dagger}, J. Ahmad, MRCS*, C. Menezes, MRCS*, W. B. Clements, FRCS* and J. A. Kennedy, FRCS*

From the * Department of Upper Gastrointestinal Surgery and the {dagger} Department of Neurology, Royal Victoria Hospital, Belfast, Northern Ireland, United Kingdom

Correspondence: Raymond Kennedy, MRCSI, RVH Belfast, 24 Ormonde Park, Northern Ireland, United Kingdom BT10 OLS. Electronic mail may be sent to rpg.kennedy{at}btinternet.com.

Achalasia is an incurable neuromuscular disorder of the esophagus, resulting from destruction of the esophageal myenteric plexus. This leads to aperistalsis and failure of the lower esophageal sphincter to relax after swallowing. Symptoms of achalasia are gradual in onset and include dysphagia, regurgitation, and weight loss. Severe malnutrition can ensue. Wernicke's encephalopathy (WE) is a serious, potentially fatal, neurologic disorder caused by thiamine deficiency (vitamin B1), classically described as presenting with a triad of ocular abnormalities, ataxia, and confusion. The incidence is uncertain, and many cases likely go unrecognized. It is usually diagnosed in the alcoholic population. We describe its onset after the successful surgical treatment of achalasia.

Journal of Parenteral and Enteral Nutrition, Vol. 31, No. 4, 324-325 (2007)
DOI: 10.1177/0148607107031004324
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