Frontiers in Endocrinology (Jul 2022)

Non-Occlusive Mesenteric Ischemia in Children With Diabetic Ketoacidosis: Case Report and Review of Literature

  • Giulio Frontino,
  • Giulio Frontino,
  • Raffaella Di Tonno,
  • Raffaella Di Tonno,
  • Valeria Castorani,
  • Valeria Castorani,
  • Andrea Rigamonti,
  • Andrea Rigamonti,
  • Elisa Morotti,
  • Elisa Morotti,
  • Federica Sandullo,
  • Federica Sandullo,
  • Francesco Scialabba,
  • Francesco Scialabba,
  • Francesca Arrigoni,
  • Francesca Arrigoni,
  • Riccardo Foglino,
  • Riccardo Foglino,
  • Benedetta Dionisi,
  • Benedetta Dionisi,
  • Chiara Irene Carla Ferri,
  • Salvatore Zirpoli,
  • Graziano Barera,
  • Franco Meschi,
  • Franco Meschi,
  • Riccardo Bonfanti,
  • Riccardo Bonfanti,
  • Riccardo Bonfanti

DOI
https://doi.org/10.3389/fendo.2022.900325
Journal volume & issue
Vol. 13

Abstract

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IntroductionDespite 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 PresentationA 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.ConclusionThe diagnosis of DKA-associated NOMI must be suspected in pediatric patients with DKA, persistent abdominal pain, and severe dehydration even after DKA resolution.

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