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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Diabetic ketoacidosis (DKA) is one of the most serious acute complications of diabetes mellitus. An arterial thrombotic tendency from DKA is relatively common; however, the occurrence of acute multiple arteriovenous thromboses is rare. We herein report the case of a 49-year-old man with DKA complicated by multiple thromboses. After transfer to our emergency room with DKA, the patient developed sudden abdominal pain. Contrast-enhanced computed tomography revealed near-complete occlusion of the superior mesenteric artery, superior mesenteric vein, splenic artery, and right femoral artery. This occurrence highlights the need for considering the risk of thrombosis during the initial treatment for DKA.
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PMID:Acute Multiple Arteriovenous Thromboses in a Patient with Diabetic Ketoacidosis. 2627 96

Abdominal pain is a common chief complaint that encompasses a broad differential diagnosis at emergency department (ED), ranging from general discomfort to life-threatening disease. Abdominal pain induced by a metabolic disorder should also be considered. Diabetic ketoacidosis (DKA) is a common complication of new-onset type 1 diabetes mellitus in young patients. Although DKA that presented to the ED with complaint of abdominal pain is not uncommon, it is precipitated by hyperthyroidism, which is rare and more complicated. Herein, we present a case of a 20-year-old women who came to our ED with the chief complaint of abdominal pain, which was actually the result of DKA caused by hyperthyroidism without underlying disease.
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PMID:Diabetic ketoacidosis as the initial presentation of hyperthyroidism. 2632 Nov 66

The aim of this paper is to review the relevant literature related to the epidemiology, pathophysiology, natural history, clinical features and treatment of fibrocalculous pancreatic diabetes (FCPD). We review the English-language literature on this topic published between 1956 and 2014. FCPD is a form of diabetes usually associated with chronic calcific pancreatitis. It has been predominantly, though not exclusively, described in lean, young adults living in tropical developing countries. Historically linked to malnutrition, the etiology of this phenotype has not been clearly elucidated, nor has there been a clear consensus on specific diagnostic criteria or clinical features. Affected individuals usually present with a long-standing history of abdominal pain, which may begin as early as childhood. Progressive pancreatic endocrine and exocrine dysfunction, consistent with chronic pancreatitis is expected. Common causes of chronic pancreatitis, such as alcohol abuse, are usually absent. Typical radiographic and pathological features include coarse pancreatic calcifications, main pancreatic duct dilation, pancreatic fibrosis and atrophy. Progressive microvascular complications are common, but diabetic ketoacidosis is remarkably unusual. Pancreatic carcinoma is an infrequently described long term complication. FCPD is an uncommon diabetes phenotype characterized by early onset non-alcoholic chronic pancreatitis with hyperglycemia, insulin deficiency and a striking resistance to ketosis.
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PMID:Fibrocalculous pancreatic diabetes. 2647 3

The development of acute abdominal pain in a laboring parturient after a previous cesarean delivery is of concern and may be the result of a potentially life-threatening condition such as uterine rupture. We present a case of a parturient with type II diabetes mellitus, who had undergone 2 previous cesarean deliveries and now presented in labor with increasing abdominal pain. An emergency cesarean delivery was performed for probable uterine rupture. Intraoperatively, the patient was noted to be severely hypocarbic with significant metabolic acidosis, and the diagnosis of diabetic ketoacidosis was established.
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PMID:Normoglycemic Diabetic Ketoacidosis in a Pregnant Patient with Type II Diabetes Mellitus Presenting for Emergent Cesarean Delivery. 2682 94

Diabetes is the fifth leading cause of death worldwide. Diabetic ketoacidosis (DKA) is a life-threatening acute complication of diabetes. The aim of this study is to investigate the clinical and biochemical characteristics of DKA among 400 patients admitted to hospital, most of whom had type 1 diabetes (n = 372; 93%). Vomiting (n = 319; 79.8%), nausea (n = 282; 70.5%), and abdominal pain (n = 303; 75.8%) were the presenting symptoms most commonly experienced by the patients. Tachycardia was the most common clinical sign noted in the patients on admission (n = 243; 61.8%). The predominant precipitating cause of DKA was noncompliance to an insulin regimen (n = 215; 54.2%). Recurrent DKA admissions in type 1 diabetes patients was higher than those with type 2 diabetes (n = 232 versus n = 9, respectively; P = 0.002). Recurrent DKA admissions in female patients were higher than in male patients (n = 167 versus n = 74, respectively; P = 0.002). Continued diabetic education (given to n = 384; 94%) and counseling on the importance of adhering to the recommended medical regime, addressing the social and cultural barriers that precipitate DKA, as well as the provision of timely medical attention may greatly reduce DKA episodes and their associated complications.
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PMID:Clinical and Biochemical Characteristics of Diabetes Ketoacidosis in a Tertiary Hospital in Riyadh. 2722 39

Type I diabetes mellitus is the most common endocrine-metabolic disorder of childhood and adolescence and diabetic ketoacidosis (DKA) can be life-threatening. The study aims at identifying precipitating factors, states epidemiological features and describes clinical presentations in children with DKA admitted to Pediatric Intensive Care Unit (PICU), King Fahad Hospital, Al-Baha, Saudi Arabia. The hospital records of 80 children admitted to PICU with DKA between January 2000 and December 2004 were reviewed. Results were compared with published data from Saudi Arabia and other countries. Age at admission ranged between 8 months and 14 years (mean = 10.7 years). Female to male ratio was 1.22:1. Consanguinity was reported among 32(40%) of all admitted children's parents. A family history of diabetes (either type 1 or 2) was reported in 59 (74%). The leading precipitating factor for DKA was infections (82.1%). An episode of DKA was the first clinical presentation of diabetes among 52(65%). The common presenting symptoms were: vomiting in 57(71.3%) and abdominal pain in 53 (66.3%). All children were dehydrated. Other signs included acidotic breathing and tachypnea each in 60%. Only two children were comatose (2.5%). Three of presenting cases were initially misdiagnosed as acute appendicitis before correct diagnosis was established. Cerebral edema occurred in one child. There were no deaths. DKA is an important cause of hospital admissions in our hospital, and 65% of newly diagnosed cases present with DKA. More effort should be put to prevent and reduce the incidence of DKA at initial presentation and later.
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PMID:Diabetic Ketoacidosis in children admitted to Pediatric Intensive Care Unit of King Fahad Hospital, Al-Baha, Saudi Arabia: Precipitating factors, epidemiological parameters and clinical presentation. 2749 70

Systemic complications related to acute pancreatitis include acute respiratory distress syndrome, multiple organ dysfunction syndrome, disseminated intravascular coagulation, hypocalcemia, hyperglycemia, and insulin dependent diabetes or diabetic ketoacidosis. In practice, the development of diabetic ketoacidosis induced by acute pancreatitis is rare and generally associated with hypertriglyceridemia. However, herein we report a case of a 34-year-old female without hypertriglyceridemia, who was diagnosed with acute pancreatitis complicated with diabetic ketoacidosis. The patient was admitted with complaints of febrile sensation, back pain, and abdominal pain around the epigastric area. Levels of serum amylase and lipase were elevated to 663 U/L and 3,232 U/L. Contrast-enhanced abdominal CT showed pancreatic swelling, peri-pancreatic fat infiltration and fluid collection. The patient was initially diagnosed with simple acute pancreatitis. Though the symptoms were rapidly relieved after initiation of treatment, severe hyperglycemia (575 mg/dL), severe metabolic acidosis (pH 6.9), and ketonuria developed at four days after hospitalization. However, serum triglyceride levels remained within the normal range (134 mg/dL). Finally, the patient was diagnosed with acute pancreatitis complicated with diabetic ketoacidosis unrelated to hypertriglyceridemia. She recovered through insulin and fluid therapy, and receives insulin therapy at the outpatient clinic.
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PMID:Acute Pancreatitis Complicated with Diabetic Ketoacidosis in a Young Adult without Hypertriglyceridemia: A Case Report. 2787 Nov 65

Normoglycemic diabetic ketoacidosis should be suspected in pregnant women presenting nausea, vomiting, abdominal pain and anorexia. We report a 39 years old woman with a 32 weeks pregnancy who sought emergency care due to hyperemesis. She was hospitalized with the following diagnoses: pregnancy hypertension syndrome, gestational diabetes, morbid obesity and poor prenatal control. The evaluation of the feto-placental unit showed perception of fetal movements, non-reactive non-stress baseline record and a biophysical profile of 6/8. Fetal maturation was initiated. Laboratory tests showed a metabolic acidosis, a low pH, an increased Gap anion, elevated ketonemia and a blood glucose of 172 mg/dl. A diagnosis of normoglycemic diabetic ketoacidosis was formulated and treatment with hydration and regular insulin according to capillary blood glucose levels was started. An emergency caesarean section was performed. The newborn weighed 2.650 kg, had a length of 46 cm, was large for gestational age, had an Apgar score of 2.7, had perinatal asphyxia, convulsive syndrome and a possible congenital cardiopathy. Once the ketoacidosis was resolved during the immediate puerperium, slow acting insulin was initiated.
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PMID:[Normoglycemic diabetic ketoacidosis in pregnancy: Report of one case]. 2807 94

Glycogenic hepatopathy (GH) is an underdiagnosed complication of uncontrolled type 1 diabetes mellitus (T1DM). It appears as an acute relapsing hepatitis with reversible transaminase elevations secondary to excessive hepatic glycogen accumulation. Patients are often asymptomatic but can present with abdominal pain, nausea and vomiting. Physical examination shows hepatomegaly without splenomegaly. GH is diagnosed by biopsy as it is clinically indistinguishable from non-alcoholic fatty liver disease (NAFLD), a more common cause of hepatic dysfunction in diabetics. Here we describe a case of GH in a patient with uncontrolled type 1 diabetes whose clinical course was complicated by drug-induced liver injury. The patient initially presented with diabetic ketoacidosis and had a mild transaminitis, thought to be due to NAFLD. She developed profound transaminase elevations while receiving treatment with newer antipsychotic medications for her bipolar disorder. Liver biopsy showed evidence of resolving glycogenic hepatopathy with signs of drug-induced liver injury. This case report reviews the pathology and pathogenesis of GH and reminds the clinician to keep GH within the differential diagnosis for severe transaminitis in a patient with type 1 diabetes mellitus.
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PMID:Drug-Induced Liver Injury in the Setting of Glycogenic Hepatopathy. 2822 73

The common presenting symptoms of pancreatic cancer are abdominal pain, weight loss, and jaundice. Pancreatic adenocarcinoma presenting with diabetic ketoacidosis is a very rare emergent clinical condition. However, pancreatic ductal cystadenocarcinoma presenting with diabetic ketoacidosis was not reported. We describe a 60-year-old man with pancreatic cystadenocarcinoma presenting with diabetic ketoacidosis as the initial manifestation. It must be kept in mind that in diabetic ketoacidosis cases, the precipitating factor may be pancreatic ductal cystadenocarcinoma.
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PMID:Diabetic ketoacidosis as the presenting manifestation of pancreatic adenocarcinoma with cystic features. 2834 65


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