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Case 23-2013: A 54-Year-Old Woman with Abdominal Pain, Vomiting, and Confusion
Ist Teil von
The New England journal of medicine, 2013-07, Vol.369 (4), p.374-382
Ort / Verlag
Waltham, MA: Massachusetts Medical Society
Erscheinungsjahr
2013
Quelle
EZB Electronic Journals Library
Beschreibungen/Notizen
A 54-year-old woman with type 2 diabetes mellitus was admitted to the hospital because of abdominal pain, vomiting, and confusion. Initial laboratory evaluation revealed a serum lactate level of 20.3 mmol per liter and a venous blood pH of 6.62. A diagnosis was made.
Presentation of Case
Dr. Sara R. Schoenfeld
(Medicine): A 54-year-old woman was admitted to this hospital because of abdominal pain, vomiting, and confusion.
The patient was in her usual health until approximately 3 days before admission, when she reportedly began to feel unwell, with weakness, chills, and skin that was abnormally warm to the touch. She self-administered aspirin, without improvement. During the next 2 days, her oral intake decreased. Approximately 22 hours before presentation, vomiting occurred. Nine hours before presentation, she began to travel home to Italy from the eastern United States. During the next 2 hours, increasing abdominal pain . . .