Abstract
Osteomalacia is a rare metabolic bone disorder. We report a case of osteomalacia developing 7 years after subtotal stomach-preserving pancreaticoduodenectomy. An 80-year-old woman underwent subtotal stomach-preserving pancreaticoduodenectomy for cancer of the ampulla of Vater 7 years ago and was followed up without recurrence. She had lower back pain and a high serum alkaline phosphatase (ALP) level. We diagnosed osteomalacia based on the findings of magnetic resonance imaging, bone scintigraphy, and hypocalcemia. Clinical symptoms and abnormal serum ALP and calcium levels improved with the administration of active vitamin D. Metabolic bone disorders are an important problem after gastrectomy. Pancreaticoduodenectomy requires wide resection from the duodenum to the upper small intestine, and monitoring not only for osteomalacia but also various digestive and absorptive disorders.
