Nakai Yoshitaka, Teramura Mari, Kusaka Toshihiro, Aoki Kentarou, Kawamura Masahito, Kikuchi Mitsuya, Oiwa Yoko, Azechi Hidemasa, Manaka Dai, Kokuryu Hiroyuki
Digestive disease Center, Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital.
Digestive disease Center, Department of General Surgery, Kyoto Katsura Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2019;116(12):1022-1029. doi: 10.11405/nisshoshi.116.1022.
This case involves a 73-year-old man who visited a clinic because he was experiencing dyspnea on exertion and acid reflux. He was diagnosed with anemia and referred for a medical check-up and treatment by his primary care physician. Iron deficiency anemia and prolonged prothrombin time were confirmed with a blood test and an abdominal enhanced CT revealed marked expansion of the afferent loop after a gastrectomy. The medical check-up revealed abnormal blood coagulation due to afferent loop obstruction, which resulted in vitamin K deficiency. He was supplemented with vitamin K, and surgery was performed for the afferent loop obstruction. Postoperatively, his anemia, nutritional status, serum vitamin K levels, and prothrombin time improved steadily. In conclusion, nutrient malabsorption may occur in cases of afferent loop obstruction and abnormal blood coagulation due to vitamin K deficiency.
