Abstract
We have experienced a case of severe malnutrition after two consecutive operations on the alimentary tract, a total gastrectomy and a massive resection of the distal small intestine together with the ileocecal valve. The patient was a 59-year-old man who underwent a total gastrectomy for gastric cancer, and a massive small bowel resection for strangulation obstruction. After these operations, he suffered from short bowel syndrome manifested by frequent bowel movements, marked loss of body weight, milk intolerance, and iron-deficiency anemia. Plasma levels of total bile acid were also markedly reduced. The patient was treated by enteral hyperalimentation, and was administered ursodeoxycholic acid and lactase in addition to digestive enzymes and conventional stegnotics. These treatmens were very effective for improving his malnourished state. Postprandial plasma total bile acid concentrations increased and the release of cholecystokinin was kept at a good level.
