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VOLUME 22 , ISSUE 12 ( 2018 ) > List of Articles

CASE REPORT

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

Johannes Heymer, Andreas Lienig, Joachim Löffler, Tobias Schilling, Daniel Räpple

Keywords : Duodenal stenosis, metabolic alkalosis, vomiting

Citation Information : Heymer J, Lienig A, Löffler J, Schilling T, Räpple D. Extreme metabolic alkalosis and acute kidney injury in a 38-year-old male patient. Indian J Crit Care Med 2018; 22 (12):883-885.

DOI: 10.4103/ijccm.IJCCM_180_18

License: CC BY-ND 3.0

Published Online: 01-04-2018

Copyright Statement:  Copyright © 2018; The Author(s).


Abstract

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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  1. Bae EH, Ma SK, Kim SW. Extreme metabolic alkalosis caused by gastrostomy tube malposition treated using conventional hemodialysis. Chonnam Med J 2016;52:217-8.
  2. Galla JH. Disease of the month metabolic alkalosis classification and definitions. J Am Soc Nephrol 2000;1:369-75.
  3. Hsu SC, Wang MC, Liu HL, Tsai MC, Huang JJ. Extreme metabolic alkalosis treated with normal bicarbonate hemodialysis. Am J Kidney Dis 2001;37:E31.
  4. Ryuge A, Matsui K, Shibagaki Y. Hyponatremic chloride-depletion metabolic alkalosis successfully treated with high cation-gap amino acid. Intern Med 2016;55:1765-7.
  5. Soliz J, Lim J, Zheng G. Anesthetic management of a patient with sustained severe metabolic alkalosis and electrolyte abnormalities caused by ingestion of baking soda. Case Rep Anesthesiol 2014;2014:930153.
  6. Jukes A, Gunew M, Marshall R. Severe muscle fasciculations and tremor in a cat with hypochloraemic metabolic alkalosis secondary to duodenal obstruction. JFMS Open Rep 2017;3:1-4.
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