The necessity of vitamin supplementation during long-term artificial nutrition is well known. Nevertheless, it may be overlooked, particularly if the disorder causing the nutrition problems dominates the therapeutic measures. This was the situation in a case of Wernicke encephalopathy that developed after prolonged parenteral alimentation.
Report of a Case.—The patient is a 14-year-old boy, previously healthy, who was admitted to another hospital for treatment of esophageal aclasis. While the patient was undergoing therapeutic dilation with bougies, the abdominal part of the esophagus was accidentally perforated. The perforation was repaired and the boy was treated with antibiotics. During this time he was nourished only parenterally. After four weeks he became febrile and somnolent. Laboratory investigation disclosed severe acidosis (base excess, −12.5) and a low serum sodium level (124 mEq/liter). After glucose infusion and correction of the acid-base and electrolyte disturbances, there was transient improvement, but his condition soon deteriorated, and