To systematically review and synthesize evidence on the incidence, clinical characteristics, diagnostic methods, management strategies, and outcomes of Wernicke encephalopathy (WE) in non-alcoholic adults following gastrointestinal procedures.
Approach:
Systematic Review: A PRISMA-compliant systematic review was conducted, searching PubMed, Scopus, Web of Science, and Embase for studies published between 2000 and 2025.
Key Findings:
The review included 13 studies involving 1,036 patients.
Diverse gastrointestinal procedures were associated with WE, with vomiting identified as the most common precipitating factor.
The classical triad of confusion, ataxia, and oculomotor dysfunction was present in only a minority of patients.
Magnetic resonance imaging showed characteristic changes in the thalami, mammillary bodies, and periaqueductal gray in confirmed cases.
Mortality rates varied from 0.3% in bariatric cohorts to 40% in oncologic patients.
Early intravenous thiamine was associated with favorable outcomes, although dosing protocols varied.
Interpretation:
WE following gastrointestinal procedures presents significant diagnostic challenges, and prophylactic thiamine supplementation should be strongly considered in high-risk patients.
Limitations:
Variability in diagnostic criteria and management strategies across studies.
Conclusion:
WE is often underdiagnosed in non-alcoholic patients following gastrointestinal surgeries, highlighting the need for increased awareness and early intervention.
