In an infant with complete ileal resection with preservation of the ileocecal valve, what is the primary nutrition-related concern?

In an infant with complete ileal resection with preservation of the ileocecal valve, what is the primary nutrition-related concern?

• A. Water soluble vitamin malabsorption
• B. Dumping syndrome
• C. Protein malabsorption due to decreased CCK secretion
• D. Decreased vitamin B12 absorption

Answer: (D)

The key issue is that vitamin B12 absorption requires the terminal ileum where the B12-intrinsic factor complex is taken up. When the ileum is completely resected, that absorption site is lost, so B12 can no longer be efficiently absorbed, even if the ileocecal valve is intact. In an infant, depleted B12 stores can lead to anemia and developmental/neurologic problems, so the primary nutrition-related concern is impaired B12 absorption and the need for ongoing B12 supplementation or monitoring. Water-soluble vitamins are generally absorbed along other segments of the small intestine, so they’re less uniquely impacted by loss of the terminal ileum. Dumping syndrome is a gastric/duodenal issue related to rapid gastric emptying, not the ileal site of nutrient absorption. Protein absorption isn’t primarily limited by CCK secretion in this context; CCK is a signal for digestion and bile release, not the main determinant of protein absorption, which isn’t the central problem here.

The key issue is that vitamin B12 absorption requires the terminal ileum where the B12-intrinsic factor complex is taken up. When the ileum is completely resected, that absorption site is lost, so B12 can no longer be efficiently absorbed, even if the ileocecal valve is intact. In an infant, depleted B12 stores can lead to anemia and developmental/neurologic problems, so the primary nutrition-related concern is impaired B12 absorption and the need for ongoing B12 supplementation or monitoring.

Water-soluble vitamins are generally absorbed along other segments of the small intestine, so they’re less uniquely impacted by loss of the terminal ileum. Dumping syndrome is a gastric/duodenal issue related to rapid gastric emptying, not the ileal site of nutrient absorption. Protein absorption isn’t primarily limited by CCK secretion in this context; CCK is a signal for digestion and bile release, not the main determinant of protein absorption, which isn’t the central problem here.