AI Article Synopsis
- A patient who underwent laparoscopic sleeve gastrectomy experienced poor oral tolerance and was misdiagnosed with diabetic ketoacidosis, leading to ineffective treatment with volume supplementation.
- The actual issue was identified as starvation ketoacidosis, which improved rapidly after administering glucose.
- This case emphasizes the importance of accurately diagnosing and managing starvation ketoacidosis after bariatric surgery, and the need for careful interpretation of elevated lipase levels without signs of pancreatitis.
Article Abstract
We report a case of post bariatric surgery by laparoscopic sleeve gastrectomy who presented with post-surgical poor oral tolerance and high anion gap metabolic ketoacidosis, who was initially misdiagnosed with diabetic ketoacidosis and treated with volume supplementation without improvement. The metabolic derangements were found to be caused by starvation ketoacidosis, which was then treated with glucose supplementation, and the anion gap quickly closed. Moreover, this patient also presented with non-pancreatitis lipase elevation. This case highlights the recognition and management of post-bariatric surgery starvation ketoacidosis; additionally, clinicians should be vigilant about the interpretation and management of elevated lipase without clinical pancreatitis.
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| http://dx.doi.org/10.1016/j.ajem.2017.10.068 | DOI Listing |
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