Diabetic Ketoacidosis and Acute Mesenteric Ischemia in Adults: An Underreported Association.
| Autor: | Vivino GR; Internal Medicine, Eastern Virginia Medical School, Norfolk, USA., Crofton NA; Internal Medicine, Eastern Virginia Medical School, Norfolk, USA., Mussarat S; Internal Medicine, Eastern Virginia Medical School, Norfolk, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Cureus [Cureus] 2022 Sep 11; Vol. 14 (9), pp. e29053. Date of Electronic Publication: 2022 Sep 11 (Print Publication: 2022). |
| DOI: | 10.7759/cureus.29053 |
| Abstrakt: | Acute mesenteric ischemia (AMI) is a rapidly fatal abdominal process that has been associated with diabetic ketoacidosis (DKA). This association has been reported among pediatric patients but has rarely been reported in adult patients. This case series presents two adult patients who presented with DKA and were subsequently found to have AMI. The first case is that of a 60-year-old male with a history of insulin-dependent type II diabetes mellitus who had a presentation and laboratory values consistent with DKA. He developed hypovolemic shock and worsening acidosis, and computed tomography angiography (CTA) revealed superior mesenteric artery occlusion. The second case is that of a 41-year-old male with a history of type I diabetes mellitus who presented with DKA and had no improvement despite aggressive resuscitation with fluids and insulin therapy. Computed tomography (CT) imaging of the abdomen revealed pneumatosis of the small bowel, indicative of ischemia. Both patients underwent bowel resection in the operating room. Given the high mortality and morbidity of AMI, it is an important diagnosis to consider in patients with DKA who have unresolving acidosis. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2022, Vivino et al.) |
| Databáze: | MEDLINE |
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