Pancreatic ketoacidosis-a rare case report

  • Dr. Dhivahar. G Consultant, Critical Care Medicine, GEM Hospital and Research Center, Tamil Nadu, India
  • Dr. Paresh Rajan Registrar, Surgical Gastroenterology, GEM Hospital and Research Center, Tamil Nadu, India
  • Dr. Raghunath D. Consultant, Critical Care Medicine, GEM Hospital and Research Center, Tamil Nadu, India
  • Dr. Shivanshu Misra Consultant Surgical Gastroenterologist and Advanced Laparoscopic Surgeon, GEM Hospital and Research Center, Tamil Nadu, India https://orcid.org/0000-0001-5160-6211
Keywords: Pancreatic ketoacidosis, Pancreatitis, Diabetes mellitus, Anion gap acidosis, Ketonuria, Ketonemia

Abstract

Euglycemic Pancreatic Ketoacidosis is a syndrome of high anion gap acidosis in which the high anion gap is due to elevated serum ketone bodies comprising of acetone, aceto- acetate and beta hydroxyl-butyrate, due to increased peripheral adipose tissue breakdown by elevated serum lipase as a consequence of acute pancreatitis with normal blood glucose levels. There are multiple causes for ketonuria and/or ketonemia with or without acidosis like uncontrolled diabetes mellitus, usually of the insulin dependent type (diabetic ketoacidosis), lactic acidosis, prolonged starvation (starvation ketosis), ethanol ingestion (alcoholic ketoacidosis), sepsis, pregnancy and vomiting. Our patient was not a known diabetic and his blood glucose were always within normal limits, so this ketoacidosis cannot be attributed to Diabetes Mellitus. It cannot be attributed to starvation as our patient was not fasting when he got admitted and furthermore ketoacidosis is not a frequent manifestation of starvation adding to it that we transfused adequate amount of DNS and resumed oral intake during our observation period. It cannot be attributed to vomiting as our patient had only two episodes of vomiting. Our patient does not have any liver or kidney pathology and there is no history or evidence of alcohol intoxication. But, acute pancreatitis without diabetes-mellitus, causing ketoacidosis is a very rare presentation which is caused by high levels of pancreatic lipase in the circulation.

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Published
2020-02-10
How to Cite
1.
G D, Rajan P, D. R, Misra DS. Pancreatic ketoacidosis-a rare case report. Int J Med Res Rev [Internet]. 2020Feb.10 [cited 2020Apr.8];8(1):136- 139. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/1136
Section
Case Report