Severe metabolic alkalosis due to the combination of unmeasured cations and hypochloraemia in a patient with gastroparesia and frequent emesis.

@article{Maciel2009SevereMA,
  title={Severe metabolic alkalosis due to the combination of unmeasured cations and hypochloraemia in a patient with gastroparesia and frequent emesis.},
  author={Alexandre Toledo Maciel},
  journal={BMJ case reports},
  year={2009},
  volume={2009}
}
This report describes a patient with gastroparesia and frequent emesis admitted with severe metabolic alkalaemia, hyperlactataemia and acute renal failure. Metabolic alkalaemia was not only due to hypochloraemia but also due to unmeasured cations. These cations were found to be present by calculating anion gap and strong ion gap (both were negative, which is rare). After massive gastric bleeding the patient had a cardiac arrest; following cardiopulmonary resuscitation and infusion of a large… CONTINUE READING