Abstract
BackgroundDiarrhea is common in patients with Crohn's disease and may be accompanied by acid base disorders, most commonly metabolic acidosis due to intestinal loss of bicarbonate.Case PresentationHere, we present a case of severe metabolic alkalosis in a young patient suffering from M. Crohn. The patient had undergone multiple resections of the intestine and suffered from chronic kidney disease. He was now referred to our clinic for recurrent acute kidney injury, the nature of which was pre-renal due to profound volume depletion. Renal failure was associated with marked hypochloremic metabolic alkalosis which only responded to high volume repletion and high dose blockade of gastric hypersecretion. Intestinal failure with stomal fluid losses of up to 5.7 litres per day required port implantation to commence parenteral nutrition. Fluid and electrolyte replacement rapidly improved renal function and acid base homeostasis.ConclusionsThis case highlights the important role of gastrointestinal function to maintain acid base status in patients with Crohn's disease.
Highlights
Diarrhea is common in patients with Crohn's disease and may be accompanied by acid base disorders, most commonly metabolic acidosis due to intestinal loss of bicarbonate.Case Presentation: Here, we present a case of severe metabolic alkalosis in a young patient suffering from M
Severe metabolic alkalosis is a rare finding in patients with Crohn's disease
In our patient metabolic alkalosis was triggered by gastrointestinal losses of volume and chloride, resulting in renal bicarbonate retention
Summary
Short bowel syndrome is a rare and devastating complication in chronic inflammatory bowel disease following functional or anatomic loss of extensive segments of the small intestine [1]. Patients are at risk to develop short bowel syndrome if the length of viable small intestine is less than 200 cm. Under such conditions the absorptive capacity and intestinal adaptation is profoundly compromised and often necessitates total parenteral nutrition. As part of complicated inflammatory bowel disease the patient underwent subtotal colectomy in 2001, multiple resections of the small intestine between 2005 and 2008, as well as rectum extirpation in 2008 The latter procedure required placement of a terminal ileostoma. Stomal fluid losses were as high as 5700 ml per day and fecal chloride excretion was substantial at 87 mmol/l (table 1).
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call