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Case Reports
. 2023 Nov 25;15(11):e49388.
doi: 10.7759/cureus.49388. eCollection 2023 Nov.

Posterior Reversible Encephalopathy Syndrome in the Immediate Postoperative Period of Gastric Cancer

Ankur K Shrivastava  1 , Narendra Kuber Bodhey  2 , Yamini Patial  1 , Saroj K Pati  2
Affiliations
Case Reports

Posterior Reversible Encephalopathy Syndrome in the Immediate Postoperative Period of Gastric Cancer

Ankur K Shrivastava et al. Cureus. .

Erratum in

Abstract

A 55-year-old female was referred to the Department of Ophthalmology with complaints of bilateral loss of vision. She had undergone subtotal gastrectomy with gastrojejunostomy and lymphadenectomy for poorly differentiated gastric adenocarcinoma in the antropyloric region the day before. On the first postoperative day, she complained of generalised weakness, drowsiness, altered sensorium, and acute, painless, bilateral loss of vision. Ocular examination revealed visual acuity as no perception of light, bilaterally, and normal pupillary light reflexes. Anterior and posterior segment examination was within normal limits. This clinical presentation of altered sensorium and cortical blindness along with characteristic radiological findings (hyperintensity on T2/fluid-attenuated inversion recovery sequence involving the bilateral parieto-occipital lobe extending in asymmetric fashion to the bilateral cerebellum, brainstem, and thalami predominantly involving the white matter with few areas of diffusion restriction on diffusion-weighted imaging sequence predominantly on the left side with gyriform pattern) confirmed the diagnosis of posterior reversible encephalopathy syndrome (PRES). In cancer patients, PRES has been reported in patients on chemotherapy regimen or two weeks after surgery for gastric cancer. Here, we want to draw attention to the fact that PRES may develop in the immediate postoperative period of gastric cancer surgery, as seen in our case.

Keywords: chemotherapy; cortical blindness; gastric cancer surgery; immediate postoperative period; posterior reversible encephalopathy syndrome.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. MRI brain coronal section showing hyperintensities in T2-weighted image in the bilateral parieto-occipital lobe extending in asymmetric fashion to the bilateral cerebellum, brainstem, and thalami predominantly involving the white matter
Figure 2
Figure 2. MRI brain coronal section showing hyperintensities in FLAIR sequence in the bilateral parieto-occipital lobe extending in asymmetric fashion to the bilateral cerebellum, brainstem, and thalami predominantly involving the white matter
FLAIR: fluid-attenuated inversion recovery
Figure 3
Figure 3. MRI brain showing few areas of diffusion restriction which were of high intensity on DWI sequence predominantly on the left side with gyriform pattern
DWI: diffusion-weighted imaging
Figure 4
Figure 4. MRI brain showing few areas of diffusion restriction which were of low intensity on the ADC map on the left side with gyriform pattern
ADC: apparent diffusion coefficient
See this image and copyright information in PMC

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