Wernicke encephalopathy as rare complication of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

Abstract

HighlightsPeritoneal carcinomatosis (PC) of gastric origin is a frequent event even in the early phase of the disease.This is the first case, to our knowledge, of Wernicke Encephalopathy (WE) complicating CRS plus HIPEC used as treatment of peritoneal carcinomatosis of gastric origin.WE is an uncommon neurological disorder characterized by a classical triad of symptoms: ataxia, ocular motor cranial neuropathies and changes in consciousness.A deficiency of thiamine is responsible for the WE syndrome.The application of Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) gives encouraging results.A deficiency of thiamine is responsible for the WE syndrome.

Beware of lethal Wernicke's encephalopathy after cytoreductive surgery with HIPEC for peritoneal pseudomyxoma: Case report of morbidity and mortality review

“…Postoperative complications described include mainly anastomotic leak and intra abdominal abscess, ileus, pulmonary complications, and chemotherapy induced hematological or renal failure [12] . In the literature, only one paper reported a Wernicke encephalopathy complicating CRS-HIPEC for gastric carcinoma [7] .…”

“…WE is a severe neuropsychiatric emergency that may be lethal in 17 % of reported cases [35] , [7] , [36] . Even when TD is compensated, only a few patients will have a complete symptom resolution, most of them may keep residual cognitive deficits consisting of memory loss, confusion, spatio-temporal disorientation, cerebellar and ocular sequelae.…”

“…From all the complications associated with this treatment, Wernicke's encephalopathy (WE) has been reported only once in the immediate postoperative course of a CRS-HIPEC for gastric carcinoma [7] .…”