Iron-Deficiency Anemia After Partial Gastrectomy

Although the mechanism for its development is not well understood, iron-deficiency anemia is a well-recognized consequence of partial gastrectomy. The reported incidence varies considerably, depending upon the criteria used to define anemia, and other factors. Rapid emptying of the gastric remnant, intestinal “hurry”, and borderline dietary-iron intake, with or without concomitant blood loss, produce malabsorption of some forms of iron that appears to be responsible for development of the deficiency. The diagnosis rests on hematological findings in the peripheral blood, the evaluation of iron stores, epithelial changes, and the response to adequate treatment. Oral iron therapy can be both effective and inexpensive and should form the mainstay of treatment.     

The Pancreozymin-Secretin Test After Partial Gastrectomy

The administration of pancreozymin and secretin to eight control patients and 18 patients after partial gastrectomy caused no rise in serum amylase levels above normal. Four postgastrectomy patients had unexplained elevations of basal serum lipase levels but in only one did the lipase increase above the basal level after stimulation.Duodenal aspirates from the control group and from one patient with a Billroth I gastrectomy showed a wide range of values for volume, bicarbonate and amylase content. This would appear to limit the diagnostic value of the test. The two-tube method used for collecting duodenal contents proved difficult.     

Neurological Disease after Partial Gastrectomy

Clinical and laboratory signs of neurological disease were found in 14 patients many years after partial gastrectomy. Vitamin B₁₂ deficiency occurred in most patients, but only those three who had signs of subacute combined degeneration of the cord and no osteomalacia responded well to treatment.