Case report highlights acute gastric dilation and metabolic acidosis in a patient with chronic alcohol use and diabetes, suggesting critical interactions of medications.
A 45-year-old male was admitted to our hospital with complaints of nausea, vomiting, and abdominal pain for the past two days. He had been receiving treatment for diabetes for 6 years. Two weeks before hospitalization, despite experiencing a loss of appetite and difficulty in eating, he continued drinking alcohol. Canagliflozin and metformin were discontinued concurrently. Laboratory findings revealed high anion gap metabolic acidosis due to elevated serum ketone bodies and mild hyperglycemia. Alcohol ketoacidosis was diagnosed on the basis of a history of excessive alcohol intake and an increased osmolarity gap. Abdominal computed tomography (CT) revealed distension of the stomach with no obstructing mass.
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Saito et al. (2026) studied this question.
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