Most common metabolic complication of gastrectomy:
Ans. (a) Iron-deficiency anemiaRef: Shackelford 7h Edition, Page 759Metabolic Abnormalities after Gastric Surgeries:* Three are common - Anemia, Bone disease and Weight loss* MC after Billroth II, but can happen after TV with GJ or Billroth* MC type of anemia is IRON DEFICIENCY anemia due to absence of acid environment for absorption of iron.* Vit B12 deficiency can also happen due to loss of Intrinsic factor production in Distal gastrectomies. This deficiency invariably happens in most of them , hence Injection Cyanocobolamine must be given every 3 months.* Folate deficiency rarely occurs. If it occurs its due to dietary deficiency* Calcium and Vit. D malabsorption happens.* Calcium deficiency due to failed absorption in duodenum and Vit D malabsorption as a part of Fat malabsorption.* Unexplained bone pain and aches will happen in metabolic bone disease. This is diagnosed by measuring Bone density. Supplement Calcium and Vit D.
Iron deficiency anemia
Megaloblastic anemia
Hypocalcemia
Osteoporosis
Stomach & Duodenum