Gastrectomy total

Persons who have had a total gastrectomy or subtotal gastric resection (when the cells producing the intrinsic factor are totally or partially removed)... 

In rats, esophagojejunostomy with total gastrectomy 97 to induce reflux of duodenal juice alone resulted in BE and esophageal adenocarcinoma in 16 weeks without any carcinogen. 

Figure 6.2 Two major surgical models of BO and OA, oesophagojejunostomy with gastric preservation (A) and oesophagojejunostomy with total gastrectomy (B). Figure 2A shows intra-luminal pH values in the animals one week after esophagojejunostomy and preservation of the stomach (adapted from Fein al.).

Vitamin 8 2 deficiency Vitamin B-12 deficiency due to malabsorption syndrome as seen in pernicious anemia Gl pathology, dysfunction or surgery fish tapeworm infestation malignancy of pancreas or bowel gluten enteropathy sprue small bowel bacterial overgrowth total or partial gastrectomy accompanying folic acid deficiency. Increased vitamin B-12 requirements Increased vitamin B-12 requirements associated... 

The most common causes of vitamin B12 deficiency are pernicious anemia, partial or total gastrectomy, and conditions that affect the distal ileum, such as malabsorption syndromes, inflammatory bowel disease, or small bowel resection. 

In contrast to other water-soluble vitamins, significant amounts (4 to 5 mg) of vitamin B-i2 are stored in the body. As a result, it may fete several years tor the clinical symptoms of B12 deficiency to develop in individuals who have had a partial or total gastrectomy (/vhq therefore, become intrinsic factor-deficient) and can no longer absorb the vitamin. 

P7. Paulson, M., and Harvey, J. C., Haematological alterations after total gastrectomy. Evolutionary sequences over a decade. J. Am. Med. Assoc. 156, 1556-1560 (1954). 

Schilling, R. F., Clatanoff, D. V., and Korst, D. R., Intrinsic factor studies. III. Further observations utilizing the urinary radioactivity test in subjects with achlorhydria, pernicious anaemia or a total gastrectomy. J. Lab. Clin. Med. 45, 926-934 (1955). 

Gafa M, Sarli L, Miselli A, Pietra N, Carreras F, Peracchia A. Sludge and microlithiasis of the biliary tract after total Gastrectomy and postoperative total parenteral nutrition. Surg Gynecol Obstet 1987 165(5) 413-18. 

Vitamin Bij (cyanocobalamin extrinsic factor) is required in folate metabolism for DNA synthesis, and a deficiency leads to pernicious anaemia. It is used to supplement the diet after certain operations that remove the site of production of intrinsic factor, such as total gastrectomy. Deficiency causes megaloblastic haemopoiesis in which there is a marked disorder of formation of erythroblasts, and can be rectified by giving hydroxocobalamin. 

Gouzi, J., Huguier, M., Fagniez, P. et al.. Total versus subtotal gastrectomy for adenocarcinoma of the gastric antrum a French prospective control study, Hww. S rg., 209, 162-166,1989. 

Bozzetti, F., Marubini, E., Bonfanti, G., et al.. Subtotal versus total gastrectomy for gastric cancer five-year survival rates in a multicenter randomized Italian trial Italian Gastrointestinal Tumor Study Group, Surg., 230, 170-178,1999. 

For methods of assay, see Swendslid ME, Halsted JA, Libby RL. Excretion of cobalt labeled vitamin B,2 after total gastrectomy. Proc Soc Exp Biol Med 83 226-228,... 

Therapy. Riboflavin is employed for the treatment of riboflavin deficiency (Marks, 1975). Deficiencies are encountered in patients who have undergone total or subtotal gastrectomy. Recommended supplementation (Table 8) for recovery is in the range of 10 to 60 mg dally and by Injection, if necessary. 

The oxyntic mucosa of the body and fundus of the human stomach are the sites of intrinsic factor secretion. Total gastrectomy is associated with cobalamin malabsorption, and unless the vitamin is administered, cobalamin deficiency will occur within 3 to 5 years. The gastric parietal cell is the source of intrinsic factor in almost all species, including humans. The protein is present... 

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