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Disturbed metabolism of bones like osteoporosis are not completely physiological in elder persons. In all cases it is needed to search for the origin. Under the intestinal factors is a slight calcium deficiency with food of a great importance for genesis of osteoporosis stimulating a occult secondary hyperparathyroidism. If vitamin D-deficiency is added a osteomalacic component is following called "Osteoporomalacia". This mixed form is typical for intestinals. Especially elder patients are endangered because the supplying of calcium and vitamin D also the calcium absorption are decreasing with getting elder. The calcium absorption is also smaller in patients with resected stomach (Billroth II). When the function in resected stomach is disturbed like in our case of afferent-loop-syndrome a osteoporosis with osteomalacic component and pathological fractures can develop. In such cases teamwork is worthwhile.
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U Häntzschel, and
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Acta pathologica et microbiologica Scandinavica. Section A, Pathology,
