Neurological disturbances and hyperdynamic shock in a patient with esophagocoloplasty |
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Authors: | L Campos JR Masclans A Ortega C Martin FJ de Latorre M Planas |
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Affiliation: | Servei de Medicina Intensiva, Hospital General, Barcelona, Spain. |
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Abstract: | A 39-year-old man, with no history of alcohol intake, who had had an esophago-ileo-colo-gastroplasty with ileotransversostomy, developed diplopia, seizures, metabolic acidosis, and cardiac failure and finally refractory hyperdynamic shock. He died 20 h after admission to our intensive care unit from cardiocirculatory collapse. Postmortem results revealed low erythrocyte transketolase activity, which was increased by 22% by in vitro addition of thiamine diphosphate (TDP effect). Cerebral pathology showed the alterations of Wernicke's encephalopathy. We discuss the possible mechanisms of fatal cardiovascular collapse and the unusual presentation of a case without a history of alcoholic intake or clinical malnutrition. |
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