儿童糖尿病酮症酸中毒并发非闭塞性肠系膜缺血：病例报告及文献复习。
Non-Occlusive Mesenteric Ischemia in Children With Diabetic Ketoacidosis: Case Report and Review of Literature.
机构信息
Department of Pediatrics, IRCCS San Raffaele Hospital, Milan, Italy.
Diabetes Research Institute, IRCCS San Raffaele Hospital, Milan, Italy.
出版信息
Front Endocrinol (Lausanne). 2022 Jul 14;13:900325. doi: 10.3389/fendo.2022.900325. eCollection 2022.
INTRODUCTION
Despite the use of technology, recurrent diabetic ketoacidosis (DKA) prevention remains an unmet need in children and adolescents with T1D and may be accompanied by life-threatening acute complications. We present a rare case of non-occlusive mesenteric ischemia (NOMI) with overt manifestation after DKA resolution and a discussion of recent literature addressing DKA-associated NOMI epidemiology and pathogenesis in children and adolescents.
CASE PRESENTATION
A 13-year-old female with previously diagnosed T1D, was admitted at our emergency department with hypovolemic shock, DKA, hyperosmolar state and acute kidney injury (AKI). Mildly progressive abdominal pain persisted after DKA correction and after repeated ultrasound evaluations ultimately suspect for intestinal perforation, an intraoperative diagnosis of NOMI was made.
CONCLUSION
The diagnosis of DKA-associated NOMI must be suspected in pediatric patients with DKA, persistent abdominal pain, and severe dehydration even after DKA resolution.
简介
尽管应用了技术，但儿童和青少年 1 型糖尿病患者仍存在反复发生的糖尿病酮症酸中毒（DKA），这一未满足的需求，并且可能伴有危及生命的急性并发症。我们报告了一例罕见的非闭塞性肠系膜缺血（NOMI）病例，在 DKA 缓解后出现明显表现，并讨论了近期文献中关于儿童和青少年 DKA 相关 NOMI 流行病学和发病机制的内容。
病例介绍
一名 13 岁女性，患有先前诊断的 1 型糖尿病，因低血容量性休克、DKA、高渗状态和急性肾损伤（AKI）而入住我院急诊科。在 DKA 纠正后，持续性轻度腹痛，尽管多次超声检查后仍怀疑肠穿孔，最终术中诊断为 NOMI。
结论
在 DKA 缓解后仍存在 DKA 相关的 NOMI 时，必须怀疑儿童患者存在持续性腹痛和严重脱水。
Zotero 插件