Severe Metabolic Acidemia After Augmentation Enterocystoplasty: Clinical Case
DOI:
https://doi.org/10.24950/rspmi/61/2017Keywords:
Acidosis, Urinary Bladder/surgeryAbstract
Hyperchloremic acidosis is a late frequent complication of augmentation ileocystoplasty, but only rarely patients develop
symptomatic acidemia. A 64-year-old woman, with history of augmentation ileocystoplasty three months before, was admitted
in the emergency department complaining of fatigue, abdominal pain, nausea and vomits. Analytical evaluation presented
an elevation of the inflammatory parameters, renal dysfunction and a slight elevation of serum amylase and lipase, as
well as severe hyperchloremic acidemia. The first diagnosis hypothesis was thought to be acute pancreatitis. However, attending to the differential diagnosis of metabolic acidemia with normal anion gap and due to bicarbonate loss, the hypothesis
of acidemia after ileocystoplasty was more consistent. Treatment with endovenous and oral bicarbonate was instituted
and clinical and analytical improvement were observed. It is essential to foresee the metabolic complications of this procedure
and consider all possible diagnoses in order to diagnose and treat early, preventing associated morbidity.
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