{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T17:05:40Z","timestamp":1784307940263,"version":"3.55.0"},"reference-count":9,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Lactic acidosis is a strong predictor of mortality in cirrhosis, reflecting both impaired hepatic clearance and systemic tissue hypoxia. We describe a 38\u2010year\u2010old man with decompensated alcohol\u2010associated cirrhosis who developed severe lactic acidosis despite stable hemodynamics and initially nondiagnostic vascular imaging. Repeat computed tomography demonstrated rectal wall thickening with mesenteric fat stranding, concerning for ischemic injury in the setting of a low\u2010flow state. The patient subsequently experienced pulseless electrical activity arrest and died. This case highlights the prognostic significance of rising lactate in cirrhosis and underscores that severe hyperlactatemia should prompt urgent evaluation for occult hypoperfusion even when early imaging is nondiagnostic.<\/jats:p>","DOI":"10.1002\/ccr3.72789","type":"journal-article","created":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T05:26:41Z","timestamp":1779514001000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Severe Lactic Acidosis in Decompensated Cirrhosis Despite Nondiagnostic Imaging"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1157-562X","authenticated-orcid":false,"given":"Nakul","family":"Ganju","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Howard University Hospital  Washington, DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chibuzor Victor","family":"Nwachukwu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Howard University Hospital  Washington, DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Santiago\u2010Gonzalez","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Howard University Hospital  Washington, DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaharyar","family":"Naeem","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Howard University Hospital  Washington, DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Azinge","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Howard University Hospital  Washington, DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adeyinka O.","family":"Laiyemo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Howard University Hospital  Washington, DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000000671"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.30151"},{"key":"e_1_2_11_4_1","article-title":"Prognostic Role of MELD\u2010Lactate in Short\u2010Term Outcomes of Patients With Cirrhosis","volume":"22","author":"Chen X. 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A.","year":"2021"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.72789","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccr3.72789","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.72789","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T16:23:08Z","timestamp":1784305388000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.72789"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,22]]},"references-count":9,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1002\/ccr3.72789"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.72789","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,22]]},"assertion":[{"value":"2026-02-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e72789"}}