A case of night blindness due to vitamin a deficiency after subtotal stomach-preserving pancreaticoduodenectomy

NAKAYAMA Ken, MATSUO Ryota, IKEDA Osamu, OKUDA Yoichi, OHKOHCHI Nobuhiro

doi:10.3919/jjsa.73.422

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Other Title

亜全胃温存膵頭十二指腸切除術後に発症したビタミンA欠乏による夜盲症の1例
症例亜全胃温存膵頭十二指腸切除術後に発症したビタミンA欠乏による夜盲症の1例
ショウレイアゼンイオンゾンスイトウジュウニシチョウセツジョジュツゴニハッショウシタビタミン A ケツボウニヨルヤモウショウノ 1レイ

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Abstract

We report a case of night blindness due to vitamin A deficiency after subtotal stomach-preserving pancreaticoduodenectomy (SSPPD), that might be caused by intra-hepatic bile duct stones, obstructive jaundice and chronic cholangitis secondary to strictures of choledocho-jejuno anastmosis.<BR>The patient was a 73-year-old woman who underwent SSPPD for intraductal papillary mucinous neoplasms (IPMN) three years earlier. One year after SSPPD, she developed strictures of choledocho-jejuno anastomosis, multiple intra-hepatic bile duct stones and obstructive jaundice, and had had recurrent bouts of chronic cholangitis for these two years.<BR>This time, she was hospitalized because of acute cholangitis. Percutaneous transhepatic cholangiodrainage, percutaneous transhepatic cholangioscopic lithotomy and balloon dilatation of the anastomosis improved cholangitis and obstructive jaundice. She also had been suffered from night blindness due to vitamin A deficiency. After intramuscular injection of vitamin A, night blindness improved immediately.<BR>It was speculated that both malabsorption of fat-soluble vitamins according to insufficiency of bile secretion and liver dysfunction due to obstructive jaundice might cause vitamin A deficiency.

Journal

Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)

Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 73 (2), 422-426, 2012

Japan Surgical Association

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