The Ileum, Site of Vitamin B12 Absorption

1963; American Medical Association; Volume: 86; Issue: 2 Linguagem: Inglês

10.1001/archsurg.1963.01310080011003

ISSN

1538-3644

Autores

Charles D. Sherman,

Tópico(s)

Hernia repair and management

Resumo

Introduction A patient who had had an elective jejunotransverse colostomy with complete exclusion of intervening bowel underwent radioactive vitamin B 12 absorption tests before and after reinsertion of 4 inches of ileum into the gastrointestinal stream. Subsequent studies showed that the site of vitamin B 12 absorption in this patient is the terminal ileum. Report of a Case A 48-year-old woman with intractable obesity (410 lb.) but in otherwise reasonably good health underwent construction of a jejunotransverse colostomy for weight reduction and control (Fig. 1, A ). The procedure left 18 inches of jejunum in normal continuity, the remainder of the small bowel and the right half of the colon being excluded. One year after surgery a Schilling test indicated no absorption of vitamin B 12 . Fourteen months postoperatively, after a steady weight loss amounting to 200 pounds, the bypass was revised by construction of a jejunoileostomy, thus introducing the absorptive

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