Wernicke encephalopathy after intragastric balloon therapy

A 32-year-old female patient with a history of diabetes and hypothyroidism was admitted with the complaints of nausea, vomiting, chest pain, abdominal distention, and reduced urine output.The patient had undergone intragastric balloon therapy (IBT) three months ago.The patient had hypotension, tachypnea, and abdominal tenderness.The patient also had congestive heart failure.Computed tomography images showed pneumomediastinum, subcutaneous emphysema in the neck, periscapular area, and the left axilla, and an intragastric balloon with a maximum diameter of 16 cm (Figures 1,2).The balloon was endoscopically removed.In the following hours, the patient developed consciousness disturbance and epileptic seizures.Neurological examination revealed horizontal jerky nystagmus and tetraparesis.Deep tendon reflexes could not be elicited.