Abstract
1. As compared with a group of 118 normal controls, 79 patients who had had a partial gastrectomy up to 15 years ago, had a significantly lower mean serum vitamin B12 level, and subnormal levels were found in 11.5 per cent; megaloblastic changes in the bone marrow were seen in 5.8 per cent. 2. The incidence of low serum vitamin B12 levels was significantly higher in proportion to the number of years after operation and a similar trend was found in the incidence of impaired absorption of vitamin B12. 3. The accumulated evidence points to a latent progressive deficiency of vitamin B12 after partial gastrectomy which in 10 years or more may become manifest clinically as megaloblastic anaemia. The cause of this deficiency may be lack of intrinsic factor due to progressive degeneration in the remnant of gastric mucosa.
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