A metabolic study following extensive resection of the small intestine for sarcoma

Abstract

1. 1. A metabolic study in a patient with extensive resection of the small intestine due to recurrent leiomyosarcoma is reported. 2. 2. The metabolic data indicate adequate absorption and utilization of nutrients. This is best illustrated by analyzing the calcium balance which improved by increasing the intake. A low urinary calcium excretion irrespective of the calcium intake was noted in the presence of normal serum calcium levels. This is indicative of compensatory efforts of the body to retain calcium. The calcium tolerance test was useful in elucidating this point. 3. 3. The fecal content of water, fat, minerals and electrolytes in the stool was increased. These losses may be due to disturbance of reabsorption of intestinal juices and of metabolites re-excreted into the intestinal canal. The fecal electrolyte content approximated the electrolyte concentration of a plasma ultrafiltrate. 4. 4. The varying degree of metabolic disturbance following intestinal resection appears to depend upon the intestinal surface available for absorption and reabsorption. 5. 5. Derangements of metabolism in cases of malignancy may be ascribed to factors other than impaired intestinal absorption. © 1953.