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Indian Journal of Critical Care Medicine
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Year : 2018  |  Volume : 22  |  Issue : 12  |  Page : 883--885

Extreme metabolic alkalosis and acute kidney injury in a 38-year-old male patient

1 Department of Internal Medicine, Stuttgart Hospital, Stuttgart, Germany
2 Ludwigsburg Hospital, Ludwigsburg, Germany

Correspondence Address:
Dr. Johannes Heymer
Stuttgart Hospital, Kriegsbergstraße 60, 70174 Stuttgart
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijccm.IJCCM_180_18

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Repeated vomiting may lead to profound loss of fluid and electrolytes. We describe a case with life-threatening acid-base disturbances due to vomiting. A 38-year-old man presented to an emergency department with weakness and decreased urine output after having vomited up to 20 times per day over a period of 7 days. Arterial blood gas analysis revealed a metabolic alkalosis with partial respiratory compensation. Initial management consisted of oxygen therapy and intravenous fluid therapy with normal saline and potassium chloride. To prevent further gastric losses of HCl, proton-pump inhibitors and metoclopramide were administered. The vomiting was caused most likely by a temporary duodenal stenosis due to portal hypertension of unknown etiology. In our opinion, this case demonstrates the successful management of a life-threatening condition by simple measures. Despite extensive diagnostic procedures, the effective treatment of the underlying condition consisted of watchful waiting.


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Online since 7th April '04
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