Rhabdomyolysis and severe haemolytic anaemia, hepatic dysfunction and intestinal osteopathy due to hypophosphataemia in a patient after Billroth II gastrectomy

Hypophosphataemic syndromes lead to appreciable morbidity and mortality. A deficiency or lack of phosphate leads to tissue hypoxia and disruption of cellular function, which may cause severe clinical complications. We present various manifestations of hypophosphataemia; in all cases, diagnosis was delayed due to lack of follow-up. We present the case of a patient with rhabdomyolysis, severe haemolytic anaemia, hepatic dysfunction and intestinal osteopathy due to hypophosphataemia complicated by gastric Billroth II anastomosis surgery. We also review the literature concerning hypophosphataemic conditions. In conclusion, the determination of serum calcium and phosphate levels should be included in the routine follow-up of Billroth II anastomosed patients. (C) 2002 Lippincott Williams Wilkins.