Question:easy
A young man met with a motorbike accident sustaining injuries to the ileum and jejunum, following which the entire ileum and part of the jejunum were resected. The patient is most likely to subsequently suffer from:
A young man met with a motorbike accident sustaining injuries to the ileum and jejunum, following which the entire ileum and part of the jejunum were resected. The patient is most likely to subsequently suffer from:
Show Hint
Which vitamin has its only absorption site in the terminal ileum?
Updated On: Jun 23, 2026
- Vitamin B12 deficiency
- Atrophic gastritis
- Constipation
- None of the above
Show Solution
The Correct Option is A
Solution and Explanation
Site-specific absorption rule. Most nutrients can be taken up over a long stretch of small bowel, but two things are absorbed ONLY in the terminal ileum: vitamin B12 and bile salts. The jejunum handles fluids, electrolytes, iron, folate, fat, protein and carbohydrate, yet it cannot rescue B12 because it lacks the dedicated transporters.
Consequence: remove the entire ileum and you remove the sole B12 uptake site, so B12 deficiency is inevitable, and bile salt loss adds fat malabsorption on top.
Rule out the rest: atrophic gastritis is a stomach problem, not an ileal one; loss of the terminal ileum and ileocaecal valve speeds transit and causes diarrhoea, the opposite of constipation; and because a real deficiency does occur, None is wrong. The answer is vitamin B12 deficiency. Ref: Bailey and Love, Short Practice of Surgery, 27th edition, 2018.
Consequence: remove the entire ileum and you remove the sole B12 uptake site, so B12 deficiency is inevitable, and bile salt loss adds fat malabsorption on top.
Rule out the rest: atrophic gastritis is a stomach problem, not an ileal one; loss of the terminal ileum and ileocaecal valve speeds transit and causes diarrhoea, the opposite of constipation; and because a real deficiency does occur, None is wrong. The answer is vitamin B12 deficiency. Ref: Bailey and Love, Short Practice of Surgery, 27th edition, 2018.
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