Difficulty in walking 10 years after gastric surgery.

Area of Science:

• Gastroenterology and Neurology
• Nutritional Science

Background:

• The case involves a 65-year-old male with a history of Polya partial gastrectomy presenting with neurological deficits.
• Symptoms included abdominal distension and difficulty walking, suggesting a neurological complication years post-surgery.

Observation:

• Neurological examination indicated an axonal sensory neuropathy.
• Abdominal CT revealed a large afferent jejunal loop, indicative of blind loop syndrome.
• Hydrogen breath test confirmed small-bowel bacterial overgrowth.

Findings:

• Serological tests showed low copper levels, a known cause of myeloneuropathy.
• The trace element deficiency was directly linked to small-bowel bacterial overgrowth.

Implications:

• This case highlights the potential for severe neurological complications secondary to malabsorption after gastric surgery.
• Effective management involves addressing bacterial overgrowth and correcting copper deficiency.
• Early diagnosis and treatment can lead to significant symptom improvement in affected patients.