title: Severe metabolic acidosis resulting from a dislocated gastric band.
abstract: A 32-year-old morbidly obese woman with an obstructing dislocated gastric band is presented. Because of prolonged vomiting, a metabolic alkalosis would be expected, but instead an impressive high anion gap acidosis was observed. Because of a highly positive urine ketone test and a high serum concentration of beta-hydroxybutyrate, a ketoacidosis caused by starvation appears to be the primary cause of this metabolic acidosis. This type of acidosis was treated successfully with intravenous administration of glucose and insulin as well as sodium bicarbonate, with urgent removal of the band.
authors.affiliation: Clinic for Anesthesiology, Ludwig-Maximilians-University Munich, Munich, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Bruegger
authors.forename: Markus
authors.initials: M
authors.lastname: Rehm
authors.forename: Louis
authors.initials: L
authors.lastname: Da Silva
authors.forename: Frank
authors.initials: F
authors.lastname: Christ
authors.forename: Udilo
authors.initials: U
authors.lastname: Finsterer
mesh_terms: D000138:Acidosis / Q000209:etiology*; D000328:Adult; D005260:Female; D005548:Foreign-Body Migration / Q000150:complications*; D017219:Gastric Outlet Obstruction / Q000209:etiology*; D015391:Gastroplasty / Q000009:adverse effects*; D006801:Humans; D019736:Prostheses and Implants / Q000009:adverse effects*