2017 Volume 53 Issue 2 Pages 277-281
Case 1: A 2-year-old boy had a history of massive bowel resection in the neonatal period due to meconium peritonitis and jejunal atresia. Only 95 cm of the jejunum without any of the ileum remained. At 2 years of age, he presented with macrocytic anemia and was diagnosed as having B12 deficiency megaloblastic anemia (MA). Vitamin B12 was intravenously administered and his anemia improved. Case 2: A 10-year-old boy had a history of massive bowel resection in the neonatal period due to intestinal atresia and only 45 cm of the jejunum with 1 cm of the ileum remained. At 10 years of age, he showed general fatigue, anorexia and odynophagia. He was initially diagnosed as having iron deficiency anemia. Oral iron preparation was administered, but it was not effective and pancytopenia developed. Finally, he was diagnosed as having vitamin B12 deficiency MA, and vitamin B12 was intravenously administered. Because vitamin B12 deficiency can cause irreversible neurological disorder, a long-term follow-up is important for short-bowel syndrome patients who may develop malabsorption. Early diagnosis and prompt treatment of vitamin B12 deficiency before the appearance of MA symptoms are necessary to prevent irreversible neurological disorder by careful long-term follow-up of such patients.
