The patient underwent gastric resection and repair, control of liver hemorrhage, and resection of proximal jejunum, leaving his GI tract in discontinuity
Describe the potential effects of surgery on this patient's ability to meet his nutritional needs.
Gastric resection and repair could inhibit acid production (thus decreasing iron, calcium and vitamin B12 absorption), intrinsic factor secretion, change gastric motility, and reduce the amount of food he is able to eat at one time initially, but the stomach will adapt over a few months and he will return to normal function. Liver hemorrhage may disrupt liver function—metabolism of fats, proteins, and carbohydrates as well as bile production and synthesis of albumin and clotting factors—which will be noticeable in the lab values and nutritional status of the patient if function is not recovered. Resection of the proximal jejunum usually has very few long-term effects because the ileum compensates for the nutrient absorption of that part of the GI tract. The colon and ileum together absorb the increased fluid load and electrolyte load efficiently and the ileum continues to absorb bile salts so that they do not reach the colon to interfere with salt and water reabsorption.
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