abdominal
pain as the first symptom presented in children with diabetic ketoacidosis
Zhang XL, MA RB, Ma JD,
Zeng XH and Zhao YM
Surgical Department of
Capital Institute of Pediatrics,
Beijing, China 100020
Objective: To study the
relationship between the abdominal pain and diabetic ketoacidosis.
Methods: Three cases
of diabetic ketoacidosis presented abdominal pain as the first symptom from
1990 through 2000 was reviewed. The first symptom in all three children was
moderate spastic abdominal pain with mild to moderate disturbance of
consciousness，with or without nausea and vomit. On physical
examination, they were all dehydrated. There was no confirmed tenderness,
muscular guard and rebound tenderness in the abdomen. Plain abdominal films
showed gastrointestinal dilatation with retention of feces. Urine retention
was found on plain X-ray film. After urinalysis and serum glucose
investigation the diagnosis were made. Their blood glucose levels were 666,
623, 518mg% respectively. The first case had a negative exploratory
laporotomy. The second case was observed for 2 days. The third case was
diagnosed within a few hours. The regular insulin was administrated
immediately introvenously after a diagnosis was confirmed, and referraled
to internal medicine department. Regular Insulin was administrated
immediately. One week or so, all their blood glucose levels were controlled
within normal ranges.
Results: All patients
recovered well and were discharged from hospital after their blood sugar
level was stabilized within normal range.
Conclusion: When an
atypical abdominal pain encountered diabetic ketoacidosis should be
differentiated.