Details

Autor(en) / Beteiligte

• Iwase, Soji
• Okayama, Naotsuka
• Imaeda, Kenro
• Kato, Takashi
• Ohguchi, Hideomi
• Hara, Kumiko
• Watanabe, Kumiko
• Yoshida, Michihiro
• Tsukamoto, Hironobu
• Joh, Takashi

Titel

A Case of an Elderly Patient with Type 1 Diabetes Mellitus Associated with Possible Ischemic Duodenitis Accompanied by Multiple Areas of Erosion and Diabetic Ketosis

Ist Teil von

• Journal of the Japan Diabetes Society, 2013/11/30, Vol.56(11), pp.856-862

Ort / Verlag

THE JAPAN DIABETES SOCIETY

Erscheinungsjahr

2013

Link zum Volltext

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• A 74-year-old female diagnosed with type 1 diabetes at 42 years of age who had a history of poor glycemic control was admitted to our hospital with abdominal pain, nausea and anorexia. Since the laboratory data on admission showed a plasma glucose level of 461 mg/dl, a finding of 3+for urinary ketone bodies and an increased inflammatory response, infectious gastroenteritis and diabetic ketosis were diagnosed. On hospital day 2, computed tomography of the abdomen was performed following a rise in the blood amylase levels. The results indicated inflammation of the head of the pancreas and edematous thickening of the duodenum. The patient's symptoms were relieved with conservative treatment. On hospital day 8, upper gastrointestinal endoscopy revealed areas of shallow multifocal erosion, ulceration and edema in the duodenum. The patient had taken neither antibiotics nor nonsteroidal anti-inflammatory drugs prior to the onset of illness. In addition, because the endoscopic and histological findings showed ischemic changes in the duodenum, ischemic duodenitis was strongly suspected. The duodenum is supplied by both the celiac and superior mesenteric arteries; therefore, ischemia is not often encountered. As no previous reports have described diabetic ketosis associated with ischemic duodenitis, we herein report this very rare case with reference to the pertinent literature.