Fig. 2

Transition of zinc supplementation and serum zinc level. Approximately 1 month after discharge following pancreaticoduodenectomy performed in July 2005, the patient experienced oral pain and dysgeusia caused by zinc deficiency (serum zinc level, 30 μg/dL). Oral zinc supplementation was inadequate, and dietary intake decreased; therefore, she was admitted to the hospital in November 2005 and administered intravenous supplementation of multi-trace elements (MTEs). (Arrow a), including zinc and high-calorie infusion. Serum zinc level increased to 99 μg/dL, and her food intake improved; hence, she was discharged 20 days after admission following intravenous zinc supplementation. However, after discharge from the hospital, intravenous zinc supplementation was discontinued, and she became hypozincemic again within a month (Arrow b); therefore, she was readmitted to the hospital at the end of December 2005. At the discharge in January 2006, a central venous port was indwelled, and home self-injection of MTEs was performed to maintain zinc levels