[Left spontaneous femoral fracture in primary hyperparathyroidism and postgastrectomy bone disease following a Billroth II stomach resection].

In the present case a primary hyperparathyroidism was aggravated by postgastrectomy bone disease and led to a spontaneous fracture of the left femur and to a pseudofracture of the right femur. Renal symptoms like concrements or nephrocalcinosis were based on the intestinal conditioned malabsorption of vitamin-D and calcium not evident. Radiologically there was a mixed pattern of ostitis fibrosa cystica generalisata von Recklinghausen and osteomalacia respectively osteoporosis based on postgastrectomy bone disease. Treatment was fully effective consisting of exstirpation of the adenoma and substitution of calcium and vitamin-D and ingestion of digestive enzymes and many little meals corresponding to the prescriptions of nutrition for partially gastrectomised patients.