Most common metabolic complication of gastrectomy:

Ans. (a) Iron-deficiency anemiaRef: Shackelford 7h Edition, Page 759Metabolic Abnormalities after Gastric Surgeries:* Three are common - Anemia, Bone disease and Weight loss* MC after Billroth II, but can happen after TV with GJ or Billroth* MC type of anemia is IRON DEFICIENCY anemia due to absence of acid environment for absorption of iron.* Vit B12 deficiency can also happen due to loss of Intrinsic factor production in Distal gastrectomies. This deficiency invariably happens in most of them , hence Injection Cyanocobolamine must be given every 3 months.* Folate deficiency rarely occurs. If it occurs its due to dietary deficiency* Calcium and Vit. D malabsorption happens.* Calcium deficiency due to failed absorption in duodenum and Vit D malabsorption as a part of Fat malabsorption.* Unexplained bone pain and aches will happen in metabolic bone disease. This is diagnosed by measuring Bone density. Supplement Calcium and Vit D.