Severe electrolyte abnormalities and paralytic ileus complicating delirium tremens

Pneumonia and cardiac arrhythmias represent the most common life-threatening complications during delirium tremens. Electrolyte abnormalities are common underlying conditions in chronic alcoholics and they may further complicate the management of patients with alcohol-withdrawal syndrome or with delirium tremens. The authors present two cases in which the clinical picture of severe paralytic ileus complicating delirium tremens was closely associated with electrolyte status and postulate that the two were cause-effect related. A careful electrolyte supplement therapy guided by a strict monitoring of electrolyte balance and renal function proved to be particularly useful in successful management.