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A Unique Clinical Experiment

CHARLES D. SHERMAN, JR., M.D.; ALLYN G. MAY, M.D.

AMA Arch Surg. 1963;86(2):187-189.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Introduction

A patient who had had an elective jejunotransverse colostomy with complete exclusion of intervening bowel underwent radioactive vitamin B₁₂ absorption tests before and after reinsertion of 4 inches of ileum into the gastrointestinal stream. Subsequent studies showed that the site of vitamin B₁₂ absorption in this patient is the terminal ileum.

Report of a Case

A 48-year-old woman with intractable obesity (410 lb.) but in otherwise reasonably good health underwent construction of a jejunotransverse colostomy for weight reduction and control (Fig. 1, A). The procedure left 18 inches of jejunum in normal continuity, the remainder of the small bowel and the right half of the colon being excluded. One year after surgery a Schilling test indicated no absorption of vitamin B₁₂. Fourteen months postoperatively, after a steady weight loss amounting to 200 pounds, the bypass was revised by construction of a jejunoileostomy, thus introducing the absorptive . . . [Full Text PDF of this Article]

Author Affiliations
ROCHESTER, N.Y.

Assistant Professor of Surgery (Dr. Sherman); Resident in Surgery (Dr. May).; Department of Surgery, University of Rochester School of Medicine.

Footnotes
Submitted for publication March 2, 1962.

This work was aided in part by a grant from the Division of Research Grants and Fellowships, National Institutes of Health, OG-22.

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