title: Persistent anemia after Roux-en-Y gastric bypass.
abstract: OBJECTIVE
  We report the case of a 42-y-old morbidly obese woman who presented persistent anemia as result of Roux-en-Y gastric bypass.
  
  
  METHODS
  The surgical procedure conducted in 1999 consisted of horizontal gastroplasty with truncular vagotomy, Roux-en-Y gastrojejunal anastomosis with an alimentary limb of 60 cm, and cholecystectomy. In 2000 a second surgery (subtotal gastrectomy, i.e., 90%, with a 50-mL gastric pouch) was performed because of failed gastroplasty. Anemia was detected approximately 1 y after the second surgery. This condition worsened significantly after an abdominal lipectomy performed in 2001. Since then, different oral iron compounds were used for treatment, but with unsatisfactory results. The subject was anemic for 4 y.
  
  
  RESULTS
  The condition was corrected only after intravenous iron administration. Iron absorptions from 3 mg of iron as ferrous ascorbate and from a standardized diet that also contained 3 mg of iron were 48.4% and 39.9%, respectively.
  
  
  CONCLUSIONS
  Iron absorption tests provided evidence that the reduction of intestinal iron absorption capacity was the most probable cause of the persistent anemia.
authors.affiliation: Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile.
authors.forename: Claudio
authors.initials: C
authors.lastname: Mizón
authors.forename: Manuel
authors.initials: M
authors.lastname: Ruz
authors.forename: Attila
authors.initials: A
authors.lastname: Csendes
authors.forename: Fernando
authors.initials: F
authors.lastname: Carrasco
authors.forename: Annabella
authors.initials: A
authors.lastname: Rebolledo
authors.forename: Juana
authors.initials: J
authors.lastname: Codoceo
authors.forename: Jorge
authors.initials: J
authors.lastname: Inostroza
authors.forename: Karin
authors.initials: K
authors.lastname: Papapietro
authors.forename: Fernando
authors.initials: F
authors.lastname: Pizarro
authors.forename: Manuel
authors.initials: M
authors.lastname: Olivares
mesh_terms: D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D001205:Ascorbic Acid / Q000493:pharmacokinetics / Q000627:therapeutic use*; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects*; D006801:Humans; D007408:Intestinal Absorption / Q000187:drug effects; D009767:Obesity, Morbid / Q000097:blood / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D001205:Ascorbic Acid