van Niekerk Christoffel, Wallace James, Takata Mark, Yu Roger
Department of Internal Medicine, Scripps Clinic - Scripps Green Hospital, La Jolla, California, USA.
BMJ Case Rep. 2018 Aug 20;2018:bcr-2017-221527. doi: 10.1136/bcr-2017-221527.
A 52-year-old type 2 diabetic man previously on canagliflozin developed severe anion gap metabolic acidosis and markedly elevated beta-hydroxybutyrate on postoperative day (POD) 2 status post laparoscopic Roux-en-Y gastric bypass. An insulin drip and aggressive intravenous fluid repletion were initiated, and electrolytes were monitored and repleted. His anion gap closed, and he was discharged on POD 4. This euglycaemic diabetic ketoacidosis prolonged his hospital stay by 2 days.
一名52岁的2型糖尿病男性患者，此前服用卡格列净，在接受腹腔镜Roux-en-Y胃旁路手术后第2天（术后日，POD）出现严重阴离子间隙代谢性酸中毒，β-羟丁酸水平显著升高。开始静脉输注胰岛素并积极补充静脉液体，同时监测并补充电解质。他的阴离子间隙恢复正常，于术后第4天出院。这种正常血糖性糖尿病酮症酸中毒使他的住院时间延长了2天。
