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Surgery Miscellaneous (Small & Large Intestine) ef6930eb

If 90% of jejunum and ilium is removed then all of the following features will be seen except -

A
Steatorrhoea
B
Diarrhoea
C
Weight gain
D
Megaloblastic anemia
High-Yield Explanation
Ans. is 'c' i.e., Weight gain Short bowel syndromeo Is the malabsorptive condition that arises secondary to removal of significant segments of the small intestineo The MC causes are Mesentric infarction, Crohns ds, Trauma * Changes seen in Terminal ileal resection# Resection of terminal ileum results in malabsorption of bile salts* and Vit. B12* which are normally absorbed in this region# Vit B12 Malabsorption : Megaloblastic anemia*# Bile salts malabsorption : Unabsorbed bile salts escape into colon where they stimulate fluid secretion from the colon, resulting in watery diarrhoea*.o Reduction in bile salt pool lead to steatorrhea* and malabsorption of fat soluble vitamins (due to malabsorption of fat).# Unabsorbed fatty acids bind with calcium, and thus lead to increased concentration of free oxalates (oxalates bind with calcium normally and therefore escape without intestinal absorption) Free oxalates are absorbed. Increased cone, of body oxalates lead to oxalate kidney stones*# Due to decreased bile salts in the bile : Cholesterol gall* stones result.o If the ileocecal valve is removed -# bacterial overgrowth from the colon: diarrhoea & malabsorption# decrease in intestinal transit timeo Resection of other segments# Duodenal resection may result in folate, Iron, or calcium malabsorption.# Large resection of intestine may result in gastric hypersecretion* d/t reduced hormonal inhibition of acid secretion# Increase gastric acido A massive resection may result in nutrients, water and electrolyte malabsorptiono Weight loss occurs because of malabsorption & diarrhoea

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