Non-Occlusive Mesenteric Ischemia in Children With Diabetic Ketoacidosis: Case Report and Review of Literature

Overview

Journal Front Endocrinol (Lausanne)

Specialty Endocrinology

Date 2022 Aug 5

PMID 35928892

Authors

Giulio Frontino

Raffaella Di Tonno

Valeria Castorani

Andrea Rigamonti

Elisa Morotti

Federica Sandullo

Francesco Scialabba

Francesca Arrigoni

Riccardo Foglino

Benedetta Dionisi

Chiara Irene Carla Ferri

Salvatore Zirpoli

Graziano Barera

Franco Meschi

Riccardo Bonfanti

Affiliations

Soon will be listed here.

Abstract

Introduction: Despite the use of technology, recurrent diabetic ketoacidosis (DKA) prevention remains an unmet need in children and adolescents with T1D and may be accompanied by life-threatening acute complications. We present a rare case of non-occlusive mesenteric ischemia (NOMI) with overt manifestation after DKA resolution and a discussion of recent literature addressing DKA-associated NOMI epidemiology and pathogenesis in children and adolescents.

Case Presentation: A 13-year-old female with previously diagnosed T1D, was admitted at our emergency department with hypovolemic shock, DKA, hyperosmolar state and acute kidney injury (AKI). Mildly progressive abdominal pain persisted after DKA correction and after repeated ultrasound evaluations ultimately suspect for intestinal perforation, an intraoperative diagnosis of NOMI was made.

Conclusion: The diagnosis of DKA-associated NOMI must be suspected in pediatric patients with DKA, persistent abdominal pain, and severe dehydration even after DKA resolution.

Citing Articles

Severe Diabetic Ketoacidosis in Children with Type 1 Diabetes: Ongoing Challenges in Care.

Foti Randazzese S, La Rocca M, Bombaci B, Di Pisa A, Giliberto E, Inturri T Children (Basel). 2025; 12(1).

PMID: 39857941 PMC: 11763767. DOI: 10.3390/children12010110.

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