Recurrent bowel necrosis from non-occlusive mesenteric ischemia induced by diabetes ketoacidosis in an adult patient causing mortality: a rare cause of mortality associated with poorly controlled diabetes in adults

Authors

  • Munasinghe Silva Department of General Surgery, Caboolture Hospital, Queensland, Australia http://orcid.org/0000-0002-3152-7564
  • Vinay Gounder Department of General Surgery, Caboolture Hospital, Queensland, Australia

DOI:

https://doi.org/10.18203/2349-2902.isj20223171

Keywords:

Diabetes ketoacidosis, Non-occlusive mesenteric ischemia, Type 2 diabetes mellitus, Bowl necrosis, Mortality

Abstract

Diabetes ketoacidosis (DKA) is associated with severe dehydration resulting in non-obstructive mesenteric ischemia (NOMI), which can contribute to severe patient complications. Recurrent episodes of NOMI with DKA in adults can be associated with mortality rarely. We presented a case of an adult patient with poorly controlled insulin-dependent type 2 diabetes mellitus due to poor socioeconomic background who presented to the emergency department with multiple episodes of bowel necrosis causing mortality.

 

Metrics

Metrics Loading ...

Author Biographies

Munasinghe Silva, Department of General Surgery, Caboolture Hospital, Queensland, Australia

Registrar, Department of General Surgery

Vinay Gounder, Department of General Surgery, Caboolture Hospital, Queensland, Australia

Consultant surgeon, Department of General Surgery

References

Ghetti S, Lee JK, Sims CE, Demaster DM, Glaser NS. Diabetic ketoacidosis and memory dysfunction in children with type 1 diabetes. J Pediatr. 2010;156(1):109-14.

Gesuita R, Maffeis C, Bonfanti R, Cardella F, Citriniti F, D'Annunzio G, et al. Socioeconomic Inequalities Increase the Probability of Ketoacidosis at Diagnosis of Type 1 Diabetes: A 2014-2016 Nationwide Study of 2,679 Italian Children. Front Pediatr. 2020;8:575020.

Itoh Y, Sagawa R, Kinoshita H, Tamba S, Yamamoto K, Yamada Y, et al. Small-intestinal necrosis due to non-occlusive mesenteric ischemia with diabetic ketoacidosis after quetiapine treatment. Diabetol Int. 2018;10(3):225-30.

Meglio LA, Chaet MS, Quigley CA, Grosfeld JL. Massive ischemic intestinal necrosis at the onset of diabetes mellitus with ketoacidosis in a three-year-old girl. J Pediatr Surg. 2003;38(10):1537-9.

Ashrafi M, Hashemipour M, Moadab MH, Jamshidi M, Hosseinpour M. Ischemic intestinal necrosis in a five-year-old girl with diabetic ketoacidosis. Arch Iran Med. 2007;10(4):529-31.

Frontino G, Tonno R, Castorani V, Rigamonti A, Morotti E, Sandullo F, et al. Non-Occlusive Mesenteric Ischemia in Children With Diabetic Ketoacidosis: Case Report and Review of Literature. Front Endocrinol (Lausanne). 2022;13:900325.

Kitabchi AE, Umpierrez GE, Murphy MB, Kreisberg RA. Hyperglycemic crises in adult patients with diabetes: a consensus statement from the American Diabetes Association. Diabetes Care. 2006;29(12):2739-48.

Dunger DB, Sperling MA, Acerini CL, Bohn DJ, Daneman D, Danne TP, et al. ESPE/LWPES consensus statement on diabetic ketoacidosis in children and adolescents. Arch Dis Child. 2004;89(2):188-94.

Wolfsdorf J, Glaser N, Sperling MA, American Diabetes Association. Diabetic ketoacidosis in infants, children, and adolescents: A consensus statement from the American Diabetes Association. Diabetes Care. 2006;29(5):1150-9.

Cashen K, Petersen T. Diabetic Ketoacidosis. Pediatr Rev. 2019;40(8):412-20.

Park JH, Muncie C, Sawaya DE. Intestinal ischemia resulting in enterectomy in poorly controlled type 1 diabetes mellitus with diabetic ketoacidosis. Jof Pediat Surg Case Report. 2022;82:102309.

Clair DG, Beach JM. Mesenteric Ischemia. N Engl J Med. 2016;374(10):959-68.

Ferriss JB, O'Hare JA, Kelleher CC, Sullivan PA, Cole MM, Ross HF, et al. Diabetic control and the renin-angiotensin system, catecholamines, and blood pressure. Hypertension. 1985;7(6 Pt 2):II58-63.

Worly JM, Fortenberry JD, Hansen I, Chambliss CR, Stockwell J. Deep venous thrombosis in children with diabetic ketoacidosis and femoral central venous catheters. Pediatrics. 2004;113(1 Pt 1):e57-60.

Oliva IB, Davarpanah AH, Rybicki FJ, Desjardins B, Flamm SD, Francois CJ, et al. ACR Appropriateness Criteria ® imaging of mesenteric ischemia. Abdom Imaging. 2013;38(4):714-9.

Henes FO, Pickhardt PJ, Herzyk A, Lee SJ, Motosugi U, Derlin T, et al. CT angiography in the setting of suspected acute mesenteric ischemia: prevalence of ischemic and alternative diagnoses. Abdom Radiol (NY). 2017;42(4):1152-61.

Dijk LJ, Petersen AS, Moelker A. Vascular imaging of the mesenteric vasculature. Best Pract Res Clin Gastroenterol. 2017;31(1):3-14.

Fitzpatrick LA, Rivers-Bowerman MD, Thipphavong S, Clarke SE, Rowe JA, Costa AF. Pearls, Pitfalls, and Conditions that Mimic Mesenteric Ischemia at CT. Radiographics. 2020;40(2):545-61.

Une K, Sumi Y, Kurayoshi M, Nakanuno R, Nakahara M. Nonocclusive mesenteric ischemia during treatment for ketoacidosis associated with acute-onset type 1 diabetes mellitus: A case report. Clin Case Rep. 2022;10(4):e05714.

Downloads

Published

2022-11-28

How to Cite

Silva, M., & Gounder, V. (2022). Recurrent bowel necrosis from non-occlusive mesenteric ischemia induced by diabetes ketoacidosis in an adult patient causing mortality: a rare cause of mortality associated with poorly controlled diabetes in adults. International Surgery Journal, 9(12), 2051–2054. https://doi.org/10.18203/2349-2902.isj20223171

Issue

Section

Case Reports