Persistent anemia after Roux-en-Y gastric bypass.
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.
Mizón
Claudio
C
Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile.
Ruz
Manuel
M
Csendes
Attila
A
Carrasco
Fernando
F
Rebolledo
Annabella
A
Codoceo
Juana
J
Inostroza
Jorge
J
Papapietro
Karin
K
Pizarro
Fernando
F
Olivares
Manuel
M
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
D001205:Ascorbic Acid