{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,1,22]],"date-time":"2024-01-22T16:22:26Z","timestamp":1705940546705},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2020,10,29]],"date-time":"2020-10-29T00:00:00Z","timestamp":1603929600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,1,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Purpose<\/jats:title>\n                  <jats:p>Although hyperglycemic crises can lead to a hypercoagulable state, few instances of associated mesenteric venous thrombosis (MVT) have been reported. Worsening abdominal pain in the context of shock requiring vasopressor support should prompt urgent further investigation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Summary<\/jats:title>\n                  <jats:p>A 44-year-old Hispanic male arrived at an emergency department with chief complaints of lethargy, polydipsia, and polyuria. His past medical history included type 2 diabetes, epilepsy, obesity, tobacco smoking, and noncompliance with his medications. On arrival the patient had a serum glucose concentration of &amp;gt;1,600 mg\/dL, and hyperosmolar hyperglycemic syndrome (HHS) was diagnosed. The patient was admitted to the intensive care unit with respiratory failure and subsequently developed shock refractory to fluid resuscitation, necessitating vasopressor support. On hospital day 4, a computerized tomogram obtained for investigation of increasing abdominal tenderness revealed superior MVT and pneumatosis intestinalis. Despite an emergency laparotomy and enterectomy, the patient ultimately succumbed on hospital day 41 due to recurrent pneumonia complicated by acute respiratory distress syndrome and septic shock.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Shock that is refractory to aggressive fluid resuscitation, necessitating pressor support, in the setting of HHS or diabetic ketoacidosis should prompt investigation for the underlying source of shock. Other etiologies, including hypovolemic, cardiogenic, and obstructive shock, should be considered; however, infection is the leading trigger of hyperglycemic crises. Although rarely reported, MVT should be considered in the diagnostic algorithm in the absence of an identified infectious source. Prompt investigation should include use of diagnostic modalities such as computed tomography to assess for MVT.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajhp\/zxaa353","type":"journal-article","created":{"date-parts":[[2020,10,29]],"date-time":"2020-10-29T14:21:21Z","timestamp":1603981281000},"page":"105-107","source":"Crossref","is-referenced-by-count":1,"title":["Mesenteric venous thrombosis: A lethal complication of hyperglycemic crises"],"prefix":"10.1093","volume":"78","author":[{"given":"Andrew","family":"Tsai","sequence":"first","affiliation":[{"name":"Robert Wood Johnson University Hospital Somerset, Somerville, NJ"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda","family":"Teichman","sequence":"additional","affiliation":[{"name":"Robert Wood Johnson University Hospital Somerset, Somerville, NJ"},{"name":"Division of Acute Care Surgery, Rutgers-Robert Wood Johnson School of Medicine, New Brunswick, NJ"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher A","family":"Butts","sequence":"additional","affiliation":[{"name":"Robert Wood Johnson University Hospital Somerset, Somerville, NJ"},{"name":"Robert Wood Johnson University Hospital Somerset, Somerville, NJ"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenny Y","family":"Cai","sequence":"additional","affiliation":[{"name":"Robert Wood Johnson University Hospital Somerset, Somerville, NJ"},{"name":"Robert Wood Johnson University Hospital Somerset, Somerville, NJ"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory L","family":"Peck","sequence":"additional","affiliation":[{"name":"Division of Acute Care Surgery, Rutgers-Robert Wood Johnson School of Medicine, New Brunswick, NJ"},{"name":"Rutgers School of Public Health, Piscataway, NJ"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher D","family":"Adams","sequence":"additional","affiliation":[{"name":"Robert Wood Johnson University Hospital Somerset, Somerville, NJ"},{"name":"Rutgers School of Public Health, Piscataway, NJ"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph S","family":"Hanna","sequence":"additional","affiliation":[{"name":"Robert Wood Johnson University Hospital Somerset, Somerville, NJ"},{"name":"Division of Acute Care Surgery, Rutgers-Robert Wood Johnson School of Medicine, New Brunswick, NJ"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,10,29]]},"reference":[{"issue":"2","key":"2021010504001980800_CIT0001","doi-asserted-by":"crossref","first-page":"60","DOI":"10.15277\/bjdvd.2014.011","article-title":"HHS \u2013 full or prophylactic anticoagulation?","volume":"14","author":"Wordsworth","year":"2014","journal-title":"Br J Diabetes."},{"issue":"1","key":"2021010504001980800_CIT0002","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1081\/ERC-120018678","article-title":"Diabetic ketoacidosis promotes a prothrombotic state","volume":"29","author":"Carl","year":"2003","journal-title":"Endocr Res."},{"key":"2021010504001980800_CIT0003","article-title":"Hyperglycemic crises: diabetic ketoacidosis (DKA), and hyperglycemic hyperosmolar state (HHS).","volume-title":"Endotext","author":"Gosmanov","year":"2000"},{"issue":"11","key":"2021010504001980800_CIT0004","first-page":"729","article-title":"Hyperosmolar hyperglycemic state","volume":"96","author":"Stoner","year":"2017","journal-title":"Am Fam Physician."},{"issue":"23","key":"2021010504001980800_CIT0005","doi-asserted-by":"crossref","first-page":"1683","DOI":"10.1056\/NEJMra010076","article-title":"Mesenteric venous thrombosis","volume":"345","author":"Kumar","year":"2001","journal-title":"N Engl J Med."},{"issue":"1","key":"2021010504001980800_CIT0006","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1002\/bjs.4459","article-title":"Systematic review of survival after acute mesenteric ischaemia according to disease aetiology","volume":"91","author":"Schoots","year":"2004","journal-title":"Br J Surg."},{"issue":"2","key":"2021010504001980800_CIT0007","doi-asserted-by":"crossref","first-page":"e195S","DOI":"10.1378\/chest.11-2296","article-title":"Prevention of VTE in nonsurgical patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines","volume":"141","author":"Kahn","year":"2012","journal-title":"Chest."},{"issue":"1","key":"2021010504001980800_CIT0008","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1053\/jcrc.2002.33030","article-title":"Abdominal pain in patients with hyperglycemic crises","volume":"17","author":"Umpierrez","year":"2002","journal-title":"J Crit Care."},{"issue":"2","key":"2021010504001980800_CIT0009","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1001\/jama.1975.03260020052026","article-title":"Abdominal pain in diabetic metabolic decompensation. 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