Rosenthal P, Pesce M
J Pediatr Gastroenterol Nutr. 1985 Aug;4(4):674-6.
A case of D-lactic acidosis in a 2 1/2-year-old child followed for 11 months is reported. The infant had previously undergone extensive small intestinal resection for midgut volvulus. Diagnosis was confirmed by measurement of plasma D-lactate. Metabolic acidosis, increased anion gap, ataxia, and lethargy in patients with small intestinal resection warrant investigation for D-lactic acidosis. The presumed etiology is absorption of D-lactic acid produced by bacterial fermentation of carbohydrate in the colon. Antibiotic treatment resulted in prompt resolution of symptoms in this case. Prospective and prolonged monitoring of acidosis in patients with small bowel resection is encouraged.
报告了一例2岁半儿童的D-乳酸酸中毒病例，随访11个月。该婴儿此前因中肠扭转接受了广泛的小肠切除术。通过测量血浆D-乳酸确诊。小肠切除术后患者出现代谢性酸中毒、阴离子间隙增加、共济失调和嗜睡，需对D-乳酸酸中毒进行调查。推测病因是结肠中碳水化合物细菌发酵产生的D-乳酸吸收。抗生素治疗使该病例症状迅速缓解。鼓励对小肠切除术后患者的酸中毒进行前瞻性长期监测。
