Abdominal Pain in Diabetic Ketoacidosis: Beyond the Obvious

Carlos Tavares Bello, Miguel Franco Gago, Francelina Fernandes, Maria Manuela Oliveira


Diabetic ketoacidosis (DKA) is a medical emergency characterized by hyperglycemia, high anion gap metabolic acidosis and elevated circulating ketone bodies resulting from severe impairment of insulin secretion and/or action. Besides dehydration, nausea and vomiting, abdominal pain is also considered to be a cardinal clinical feature of DKA. Diagnosis relies on biochemical criteria, and disease severity on clinical and laboratory findings. Radiological investigation is not standard of care of DKA despite being required in specific situations. The authors report on a case of a patient with DKA and abdominal pain, whose investigation revealed chronic pancreatitis and a massive splenic artery pseudoaneurysm. The case is remarkable for the rarity of the clinical entity and reminds the clinician to the importance of imaging in newly diagnosed diabetes.

J Endocrinol Metab. 2018;8(2-3):43-46
doi: https://doi.org/10.14740/jem494w


Abdominal pain; Diabetic ketoacidosis; Chronic pancreatitis; Splenic artery pseudoaneurysm

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