BOF: 17
A 25 year old male who is
known to have insulin dependent diabetes mellitus presents with nausea,
vomiting and abdominal pain. He has a tachycardia, a postural drop in blood
pressure. He is hyperglycaemic and has ketonuria. The clinical feature that
will help differentiate abdominal pain due to diabetic ketoacidosis from a
surgical emergency is:
a) Postural hypotension
b) The presence of diarrhoea
c) Abdominal pain preceding the onset of vomiting
d) Vomiting preceding the onset of abdominal pain
e) Colicky pain in the right iliac fossa
Answer:
d)
Abdominal pain may be a
feature of diabetic ketoacidosis. It is usually a dull, persistent discomfort
centred on the umbilicus. If vomiting precedes the onset of abdominal pain it
is more likely to be due to ketoacidosis than to be a surgical emergency.
