“…This deficiency of fat-soluble vitamins may be attributed to poor nutritional intake, maldigestion, and malabsorption, or, in the case of vitamin A deficiency, impaired hepatic release of vitamin A. 6,7 Because intestinal adaptation occurs with time, it had previously been suggested that vitamin deficiency might be a transient phenomenon occurring during the early postoperative period followingJI bypass. However, it has been demonstrated that decreased serum concentrations of carotene exist for as long as 12-15 months after surgery," and our patient had a low serum concentration of vitamin A 20 yr after JI bypass surgery.…”