Severe Vitamin B12 Deficiency in an Elderly Woman Underwent Total Gastrectomy and Total Esophagectomy with Ileum-Right Colon Reconstruction

Vitamin B12 deficiency-associated symptoms include fatigue, neurological symptoms such as tingling sensations, memory difficulties, and anemia. Certain populations face an elevated risk of vitamin B12 deficiency. For instance, vegetarians are susceptible to vitamin B12 deficiency due to the absence of animal-derived foods in their diet. Similarly, older adults and individuals with gastrointestinal disorders like Crohn's disease or celiac disease are more likely to experience malabsorption issues, predisposing them to an increased risk of vitamin B12 deficiency. Furthermore, individuals with a history of total gastrectomy are exceptionally predisposed to developing vitamin B12 deficiency. This case report presents the case of an 80-year-old woman who underwent total gastrectomy and esophagectomy with ileum-right colon reconstruction and severe vitamin B12 deficiency. She exhibited general weakness and rapidly progressing cognitive impairment. We also reviewed the literature to provide current insights into the symptoms, risk factors, and treatments.