Question:
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:
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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
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The Correct Option is A
Solution and Explanation
Correct option: Vitamin B12 deficiency.
Step 1: The terminal ileum is the ONLY site where vitamin B12 (bound to intrinsic factor) and bile salts are actively absorbed, because the specific transporters exist only there.
Step 2: With the entire ileum resected, those transporters are lost, so vitamin B12 can no longer be absorbed, leading to B12 deficiency. Bile salt loss also exceeds the liver's capacity to synthesise more, causing fat malabsorption.
Why the others are wrong: Atrophic gastritis is a gastric mucosal disease (autoimmune or H. pylori related), not a consequence of ileal resection. Loss of ileum and the ileocaecal valve causes diarrhoea, not constipation. Since a clear deficiency does result, option D is incorrect.
Ref: Bailey and Love, Short Practice of Surgery, 27th edition, 2018.
Step 1: The terminal ileum is the ONLY site where vitamin B12 (bound to intrinsic factor) and bile salts are actively absorbed, because the specific transporters exist only there.
Step 2: With the entire ileum resected, those transporters are lost, so vitamin B12 can no longer be absorbed, leading to B12 deficiency. Bile salt loss also exceeds the liver's capacity to synthesise more, causing fat malabsorption.
Why the others are wrong: Atrophic gastritis is a gastric mucosal disease (autoimmune or H. pylori related), not a consequence of ileal resection. Loss of ileum and the ileocaecal valve causes diarrhoea, not constipation. Since a clear deficiency does result, option D is incorrect.
Ref: Bailey and Love, Short Practice of Surgery, 27th edition, 2018.
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