The Clinical and Metabolic Consequences of Total Gastrectomy

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Abstract
The incidence of anaemia and of iron, vitamin B12, and folate deficiency after total gastrectomy was studied in twenty cases and the literature on these subjects reviewed. Iron deficiency was common and was often multifactorial in origin. For reasons which are not clear some patients never became iron deficient. The mean time of presentation with megaloblastic anaemia in six cases was just over four years. The pattern of serum vitamin B12 levels after operation was a rapid fall to borderline values, followed by a long period of borderline values. The serum B12 was found to rise, probably owing to neoplastic deposits in liver in two cases. Folate deficiency, probably of dietary origin, was found in one case.