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Related Experiment Videos

Hypocalcaemic seizures following gastrectomy.

L S Taitz, J K Wales, L Spitz

    European Journal of Pediatrics
    |October 1, 1983
    PubMed
    Summary

    Two infants developed hypocalcemia (low calcium) and rickets after stomach removal surgery for esophageal anomalies. Treatment with vitamin D resolved these serious complications, highlighting a rare risk of gastric surgery in infants.

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    Area of Science:

    • Pediatric Surgery
    • Pediatric Endocrinology
    • Nutritional Deficiencies

    Background:

    • Subtotal gastrectomy is a rare surgical procedure in infants, often necessitated by congenital anomalies like tracheo-esophageal anomalies.
    • Complications following major gastrointestinal surgery in neonates and infants can be severe and require specialized management.
    • Nutritional deficiencies, particularly vitamin D deficiency, can arise from significant alterations in gastrointestinal anatomy and function.

    Observation:

    • Two infants presented with severe hypocalcemia (low blood calcium) and clinical/radiological evidence of rickets.
    • Presenting symptoms included grand mal seizures, a critical sign of severe hypocalcemia.
    • Both patients exhibited elevated parathyroid hormone levels, indicating a secondary response to chronic hypocalcemia.

    Findings:

    • The reported cases demonstrate a link between subtotal gastrectomy in infancy and the subsequent development of vitamin D deficiency-induced hypocalcemia and rickets.
    • Parenteral vitamin D therapy was effective in correcting the biochemical abnormalities (hypocalcemia, elevated parathyroid hormone) and resolving the bone changes and clinical symptoms.
    • This represents the first documented instance of vitamin D deficiency as a complication of gastric surgery in the infant population.

    Implications:

    • Subtotal gastrectomy in infants, though rare, carries a risk of significant metabolic complications, including vitamin D deficiency and hypocalcemia.
    • Early recognition and aggressive management with vitamin D supplementation are crucial for patients undergoing such procedures.
    • Further research into long-term nutritional monitoring and management strategies for infants following gastric surgery is warranted.

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