Abdominal pain in diabetic metabolic decompensation. Clinical significance
I. W. Campbell, L. J. Duncan, J. A. Innes, A. C. MacCuish and J. F. Munro
Severe abdominal pain and tenderness occured in 46 of 211 episodes of
severe diabetic metabolic decompensation. No association was found between
abdominal pain and the degree of dehydration or the initial blood glucose
level. In 17 instances, the abdominal pain could be attributed to the
precipitating cause of the metabolic decompensation. The episodes of
unexplained pain all occurred insulin-dependent patients less than 40 years
of age; of these, only three had a plasma bicarbonate level greater than 10
mEq/liter, and in two patients, additional factors could account for the
relative lack of ketoacidosis. Abdominal pain occurring in patients more
than 40 years old, irrespective of the plasma bicarbonate level, and in
patients of any age with a plasma bicarbonate level in excess of 10
mEq/liter, almost invariably indicates a specific underlying cause.
