A study of malabsorption after resection of the entire jejunum and the proximal half of the ileum

Abstract

SYNOPSIS Biochemical, haematological, and radiological investigations are reported in a young child in whom nearly 80% of the small intestine was resected. The prognosis in a child after such extensive resection is probably better than in an adult, as natural growth can still occur with the expectation of greater adaptability as well as of increased length of the remaining segments.The supreme role of the small intestine in digestion and absorption makes it an indispensable organ. Elaboration of the functions of its several parts is of considerable importance because of its involvement at different levels by a variety of diseases and anatomical lesions. Although special techniques (Borgstrom, Dahlqvist, Lundh, and Sjovall, 1957;Blomstrand, 1958;Cox, Meynell, Cooke, and Gaddie, 1958; Booth and Mollin, 1959) (Fig. 1). He was at that time a bright, underweight child with a protuberant abdomen. His diet was similar to that of a 6-month-old infant, and it was noted that milk feeds tended to pass through quickly. He was subject to attacks of prostration with episodes of vomiting and diarrhoea.It was at that stage, two months post-operatively, that our investigations began. His haemoglobin was 88 % (12-8 g.), red and white blood cell counts were normal, reticulocytes 0-6 %, and prothrombin time normal.

Neuromuscular disease in patients with steatorrhoea.

“…Reports of 12 patients with documented steatorrhoea followed for at least one year and up to seven years after resection failed to reveal any neuropathy; tetany, however, was not uncommon (Anderson, 1965;Opie, Hunt, and Finlay, 1964;Booth, MacIntyre, and Mollin, 1964;Clayton and Cotton, 1961;Todd, Dittebrandt, Montague, and West, 1940;Berman, Ulevitch, Haft, and Lemish, 1950;Bothe, Magee, and Driscoll, 1954;Trafford, 1956;Linder, Jackson, and Linder, 1953). Eight other patients with massive resections showed no neurological abnormalities (Althausen, Doig, Uyeyama, and Weiden, 1950;Berman, Habegger, and Billings, 1953;Fletcher, Henley, Sammons, and Squire, 1960;Holman, 1944;Martin, Robertson, and Dennis, 1948;Mayer and Criep, 1949;Pincus, 1951).…”

Massive resection of the small intestine in infancy

“…The steatorrhoea was reduced by a modification of the diet, animal fat being replaced by vegetable fat as olive oil and the fluid intake was restricted, particularly the milk (Clayton and Cotton, 1961). In Case 6 the last 10 cm.…”

Idiopathic Hypercalcuria in a Child

“…An initial five-day calcium balance (balance study I) as described by Clayton and Cotton (1961) showed definite hypercalcuria ( Fig. 1 and Table 3).…”