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This abstract is assigned to session AOB and FRO E-Posters

Title	Wernicke’s encephalopathy after sleeve gastrectomy : a matter of life ophthalmological diagnosis
Abstract Nr.	3018

Purpose	To present a clinical case of Wernicke’s encephalopathy (WE) after sleeve gastrectomy with ocular manifestation as initial symptoms.
Methods	We report a case of a 19-year-old woman who had a sleeve gastrectomy 2 months before and came with complaints of acute bilateral vision loss, diplopia, photophobia, walking difficulty and vomiting. The ophthalmological examination showed vertical nystagmus in all gaze position, impaired abduction on the left eye and best-corrected Snellen distance visual acuity < 1/20 on both eyes. Fundus showed papillary and retinal hemorrhages.
Results	WE is a severe neurological disorder due to thiamine deficiency mainly secondary to chronic alcohol consumption and is characterized by the triad ophthalmoplegia, motor ataxia and confusion. The cases of WE after bariatric surgery are fortunately infrequent (0.05% in the United States in 2007²). Most were seen within 6 months after surgery. Although ophthalmoplegia in WE is well documented, fundus abnormalities are less so and can present as optic neuritis, retinal flame hemorrhage, telangiectasia or may be normal. Serological examinations and brain magnetic resonance (MRI) may be very useful for the diagnosis.
Conclusion	Wernicke’s encephalopathy is a medical emergency due to thiamine deficiency and any therapeutic delay may result in permanent neurological damage or death. It should be born in mind especially after bariatric surgery. In case of WE suspicion, glucose perfusion should be avoided and treatment with thiamine should begin as soon as possible without waiting for any imaging or laboratory confirmation results.
Conflict of interest	No

Authors 1

Last name	PREUD'HOMME
Initials	B
Department	Hôpital Erasme
City	Bruxelles

Authors 2

Last name	DEPASSE
Initials	F
Department	Hôpital Marie Curie
City	Charleroi

Authors 3

Last name	VAUTHIER
Initials	L
Department	Hôpital Marie Curie
City	Charleroi

Authors 4

Last name	CORDONNIER
Initials	M
Department	Hôpital Erasme
City	Bruxelles