Alexander Sorisky, MD; John T. Devlin, MD
Starvation is one cause of increased anion-gap metabolic acidosis; elevated levels of beta-hydroxybutyrate and acetoacetate can cause ketoacidosis. During starvation ketosis, the usual beta-hydroxybutyrate: acetoacetate ratio is 4:1, which reflects the mitochondrial redox potential. Clinically significant ketoacidosis due to starvation takes 1 to 2 weeks to develop (1). We report a case of acute intraoperative ketoacidosis in a non-diabetic patient.
A 47-year-old woman with a history of intermittent menorrhagia was diagnosed as having endometrial carcinoma 1 month before hospitalization for a radical hysterectomy. On learning of the diagnosis, she started a restricted-calorie macrobiotic diet. During the month before surgery, she
Sorisky A, Devlin JT. Intraoperative Ketoacidosis and Malnutrition. Ann Intern Med. ;109:337–338. doi: 10.7326/0003-4819-109-4-337
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Published: Ann Intern Med. 1988;109(4):337-338.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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