A 74-year-old woman was admitted to the hospital for obtundation and anuria after five days of abdominal pain and vomiting.
The patient had a history of DM treated with metformin (850 mg/8h) and glibenclamide.
Blood pressure was 105/60 mmHg, heart rate was 155 beats/minute and temperature was 36.7o C. On physical examination, the patient showed weak peri-talsis defenselessness, abdominal disorientation, Ku's pain.
Table 2 shows the main analytical data, highlighting hypercholesterolemia of 2,605 U/l.
Abdominal computed tomography revealed an enlarged head of the pancreas suggestive of acute pancreatitis.
After stopping metformin, the patient was intubated orotracheally and mechanically ventilated.
He also received fluid-based treatment with potassium supplements, noradrenaline, bicarbonate, insulin, amiodarone, imipenen and furosemide.
On the second day of admission, after administration of 750 mEq of bicarbonate and 140 mEq of potassium, the acid-base balance was normalized (pH 7.41 and bicarbonate 20 mEq/l), and the acid-base status was determined at a
The endoscopic sample was reported as a villous adenoma of the rectum.
On the seventh day of admission the patient was extubated, and two days later she was transferred to the ward for removal of the adenoma
