What permanent deleterious effects are seen, if 25% of the small intestine is resected?
## Core Concept
The small intestine plays a crucial role in nutrient absorption, and its resection can lead to various complications. The extent of resection and the specific part of the intestine removed determine the severity of the effects. The small intestine is approximately 6 meters long and is divided into the duodenum, jejunum, and ileum.
## Why the Correct Answer is Right
If 25% of the small intestine is resected, the body can still maintain a significant level of nutrient absorption due to the large surface area of the intestine and its adaptive capabilities. However, the extent of the resection that can be tolerated varies depending on the individual's overall health, the presence of any underlying intestinal disease, and the segment of the intestine removed. Generally, resections of up to 50% of the small intestine can often be managed without severe long-term consequences, but this can depend on the location and the patient's preoperative intestinal function.
## Why Each Wrong Option is Incorrect
- **Option A:** This option is incorrect because a 25% resection is generally considered within the range that can be compensated for by the remaining intestine, especially if the resection is done for a condition like a tumor or a benign process and the remaining intestine is healthy.
- **Option B:** This option is incorrect as it implies a much more extensive resection than what is stated in the question.
- **Option C:** This option might seem plausible but does not accurately reflect the typical consequences of a 25% small intestine resection. Significant malabsorption issues usually arise with more extensive resections.
- **Option D:** While some degree of malabsorption can occur, stating that it leads to "permanent deleterious effects" might be too absolute for a 25% resection, as the body can adapt.
## Clinical Pearl / High-Yield Fact
A key point to remember is that the jejunum and ileum have different absorption capacities. The jejunum is primarily responsible for iron and calcium absorption, while the ileum absorbs vitamin B12 and bile salts. Resection of the ileum can lead to vitamin B12 deficiency and issues with bile salt absorption, potentially causing diarrhea.
## Correct Answer: B.