title: Intestinal ileus as a possible cause of hypobicarbonatemia.
abstract: The possible occurrence of metabolic acidosis in patients with intestinal ileus is not well recognized. We describe a patient with acute alcohol-induced pancreatitis and a large transverse colon ileus in which plasma bicarbonate dropped rapidly in the absence of an increase in the plasma anion gap. The urinary anion gap and ammonium excretion were consistent with an appropriate renal response to metabolic acidosis and against the possibility of respiratory alkalosis. The cause of the falling plasma bicarbonate was ascribed to intestinal bicarbonate sequestration owing to the enhancement of chloride-bicarbonate exchange in a dilated paralyzed colon.
authors.affiliation: Division of Nephrology and Hypertension, Northwestern University Feiberg School of Medicine, Chicago, IL, USA.
authors.forename: Andres
authors.initials: A
authors.lastname: Serrano
authors.forename: Rajani K
authors.initials: RK
authors.lastname: Chilakapati
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Ghanayem
authors.forename: Yemin
authors.initials: Y
authors.lastname: Yuan
authors.forename: Jeffery
authors.initials: J
authors.lastname: Alberts
authors.forename: Cathy
authors.initials: C
authors.lastname: Stephen
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Rombola
authors.forename: Daniel
authors.initials: D
authors.lastname: Batlle
mesh_terms: D000471:Alkalosis / Q000175:diagnosis* / Q000209:etiology*; D003937:Diagnosis, Differential; D006801:Humans; D007418:Intestinal Pseudo-Obstruction / Q000150:complications* / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D019283:Pancreatitis, Acute Necrotizing / Q000150:complications* / Q000175:diagnosis*