Case report reveals diabetic ketoacidosis leading to non-occlusive mesenteric ischemia, highlighting the need for vigilance.
An 81-year-old man was brought to our institution because of general fatigue, loss of appetite, and decreased consciousness. Based on the clinical findings, the patient was diagnosed with diabetic ketoacidosis (DKA) and started on insulin therapy. Two days after normalization of the ketone body level, he developed a high fever and abdominal pain. Imaging findings revealed a necrotic lesion in the intestine, and surgery was performed. Macroscopic findings showed a necrotic lesion and no thrombi. Finally, the patient was diagnosed with non-occlusive mesenteric ischemia (NOMI). We should be aware of the possibility of NOMI in subjects with DKA, especially those who have abdominal pain even after normalization of ketone body levels.
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Kimura et al. (2025) studied this question.
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