Massive ischemic intestinal necrosis at the onset of diabetes mellitus with ketoacidosis in a three-year-old girl.
A previously healthy 3-year-old girl had severe diabetic ketoacidosis complicated by hypovolemic shock. When her abdominal pain and acidosis failed to improve despite vigorous fluid resuscitation and insulin therapy, further investigation found an intestinal perforation. At laparotomy, gangrenous bowel was found, requiring an extensive enterectomy from the distal jejunum to the transverse colon; less than 90 cm of viable small intestine remained. The child survived a complicated postoperative course and currently is thriving on a normal diet.
Section of Pediatric Endocrinology and Diabetology, Department of Pediatrics, Indiana University School of Medicine and J.W. Riley Hospital for Children, Indianapolis, IN 46202, USA.
Linda A
LA
DiMeglio
Mark S
MS
Chaet
Charmian A
CA
Quigley
Jay L
JL
Grosfeld
D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D016883:Diabetic Ketoacidosis / Q000150:complications*; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D007422:Intestines / Q000098:blood supply* / Q000000981:diagnostic imaging; D007511:Ischemia / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D007813:Laparotomy; D009336:Necrosis; D010288:Parenteral Nutrition; D011859:Radiography