Manganese deposition in basal ganglia due to perioperative parenteral nutrition following gastrointestinal surgeries.

BACKGROUND/AIMS: Serial changes in blood manganese (Mn) levels and brain MRI examinations following perioperative parenteral nutrition (PN) were investigated.

METHODS

Six cases undergoing pancreatoduodenectomy (PD), 4 cases undergoing thoracic esophagectomy (TE), 18 cases undergoing total gastrectomy (TG) and 20 cases undergoing colorectal surgeries (CR) with daily administration of 20 micromol of Mn per day were studied. Cases undergoing PD, TE, TG or CR without Mn administration served as controls.

RESULTS

Hyperintense lesions in the basal ganglia on T1-weighted MRI and elevated blood Mn levels were recognized after PN in 4 of 6 cases in the PD group, in 3 of 4 cases in the TE group, in 1 of 18 cases in the TG group and in 2 of 20 cases in the CR group. No abnormalities were recognized in the control groups.

CONCLUSION

The possible Mn deposition in the basal ganglia caused by perioperative PN should be especially noted in cases undergoing PD or TE.