Clinical Analysis of a Case of EDKA Presenting with Acute Abdomen

Abstract

This study aims to explore the diagnostic and therapeutic methods for a patient with Euglycemic Diabetic Ketoacidosis (EDKA) presenting primarily with acute abdomen. On December 12, 2021, our hospital admitted a patient who experienced abdominal pain and vomiting after drinking alcohol. Upon admission, the patient underwent laboratory tests including blood glucose, complete blood count, renal function, liver function, cardiac enzyme profile, urinalysis, and electrolytes, as well as gastroscopy. Based on the results of blood gas analysis and urine ketone bodies, combined with a history of type 2 diabetes mellitus, alcohol consumption, and recent oral administration of dapagliflozin, the patient was diagnosed with EDKA. The treatment involved large volumes of fluid replacement and administration of insulin with glucose to clear ketones. The patient's urine ketone levels gradually returned to normal, abdominal pain symptoms were relieved, and the patient was discharged in good condition. The incidence of EDKA is relatively low, making it prone to misdiagnosis or missed diagnosis in clinical practice, which can delay treatment. Therefore, it is essential for physicians to be vigilant, integrate the results of various examinations, past medical history, and other factors for early and accurate diagnosis to formulate targeted treatment plans and improve patient prognosis.