Ischemic intestinal necrosis in a five-year-old girl with diabetic ketoacidosis

Diabetic ketoacidosis is a major source of morbidity and mortality in children and adolescents with type I diabetes mellitus. Although diabetic ketoacidosis is often associated with dehydration and electrolyte disturbances, cases with gastrointestinal tract complications due to shock remain particularly unusual. Herein, we reported on a five-year-old girl who had severe diabetic ketoacidosis complicated by hypovolemic shock. Her abdominal pain and acidosis despite vigorous fluid resuscitation and insulin therapy failed to improve. Further investigations showed intestinal problem. At laparatomy gangrenous bowel--about 20 cm long--near the distal ileum was found. Entrectomy and ileo-jejunal anastomosis was done and the child survived.