Related Experiment Videos
D-lactic acidosis: a treatable encephalopathy in pediatric patients
1Department of Pediatrics, Sheba Medical Center, Tel Hashomer, Israel.
Insights
Infants with short bowel syndrome may develop D-lactic acidosis and encephalopathy from enteral feeding. Early treatment with antibiotics and stopping feeding rapidly resolves this condition.
Area of Science:
- Pediatric Gastroenterology
- Neonatal Medicine
- Clinical Nutrition
Background:
- Short bowel syndrome (SBS) in infants can lead to complex metabolic disturbances.
- Enteral feeding in SBS patients may precipitate hyperchloremic acidosis with a large anion gap.
- D-lactic acidosis is a potential complication, particularly in pediatric patients with SBS.
Abstract:
A 20-month old infant, who had short bowel syndrome following extensive surgery for a mid gut volvulus, developed hyperchloremic acidosis, with a large anion gap after enteral feeding was instituted. The organic acidosis was at least partly due to an increased concentration of D-lactic acid. This patient, as did five other pediatric patients, presented with a typical encephalopathy syndrome. Early recognition of this syndrome and treatment with an intestinal antibiotic and discontinuation of enteral feeding enabled prompt correction of the hyperchloremic acidosis and a rapid clinical recovery.