The critical care consultant makes a diagnosis of refeeding syndrome. She is given packed red blood cells to improve the delivery of oxygen to peripheral tissues. She is given additional phosphate in her intravenous fluids and plasma as well as albumin. The serum phosphorus and albumin are returned to normal levels. The patient develops mutli-organ failure and bleeds from the stomach.
Blood is given to replace what is lost.
Bleeding from the left gastric artery distribution is found by angiography and that artery is embolized. The patient dies. The patient attempts to eat a variety of foods but continues to vomit. At three and one half months postoperatively, the patient develops double vision and is noted to have lateral nystagmus and loss of deep tendon reflexes. She is unsteady on her feet and extremely weak.