A case of persistent severe abdominal pain caused by type 1 diabetic ketoacidosis

We herein report a case of a 31-year-old man suffered from type 1 diabetic ketoacidosis (DKA) complicated with severe abdominal pain. On admission, his blood glucose content was 17.58 mmol/L, pH value of blood was 7.286, urine ketone body content was 3+ and the clinical examination showed no signs of acute abdominal diseases such as pancreatitis. After active treatment, the patient's acidosis was corrected quickly, but abdominal pain was not improved. After 7 days of continuous treatment with insulin pump, the urinary ketone body was finally eliminated and then the abdominal pain disappeared. This shows the importance of eliminating the ketone body in the urine. DKA with abdominal pain as the first symptom is relatively rare in the clinic. At present, the mechanism of DKA causing abdominal pain is not clear and it may be related to the stimulation of the gastrointestinal tract by ketosis metabolites. It is worth mentioning that this case has the characteristics of persistent severe abdominal pain and recurrent episodes.