{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T02:55:45Z","timestamp":1770087345771,"version":"3.49.0"},"reference-count":14,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background and Clinical Significance: Metabolic alkalosis is the most common acid\u2013base disturbance in hospitalized and critically ill patients, with extreme alkalemia (pH &gt; 7.65) linked to mortality rates exceeding 80%. Jejunostomy-related intestinal losses can lead to severe hypochloremic metabolic alkalosis, a rare but life-threatening condition. This case report highlights the clinical presentation, diagnostic approach, physiopathology, management, and outcome of a patient with extreme metabolic alkalosis induced by a temporary jejunostomy. Case Presentation: We report the case of a 72-year-old female who presented with severe alkalemia, seizures, and signs of profound dehydration following extensive enteral resection with end-jejunostomy. Serial arterial blood gas and serum electrolyte monitoring guided treatment, prompting the initiation of an aggressive chloride-based rehydration protocol. Concurrent evaluations revealed renal impairment and an intercurrent infection. Initial tests revealed extreme metabolic alkalosis (pH 7.757, HCO3\u2212 72.7 mmol\/L) with severe hypochloremia, hypokalemia, and acute kidney injury. Administration of approximately 5 L of isotonic saline with added potassium chloride over the first 6 h led to rapid improvement in pH to near-normal levels. Over the following six days, continued electrolyte correction restored physiological acid\u2013base balance and renal function. After achieving metabolic stabilization, the jejunostomy was surgically reversed. Conclusions: Extreme metabolic alkalosis secondary to jejunostomy is rare but potentially fatal. Prompt recognition of chloride-responsive alkalosis and rapid initiation of aggressive volume and electrolyte replacement are essential for survival. Definitive management requires addressing the underlying cause, such as restoration of gastrointestinal continuity, to prevent recurrence.<\/jats:p>","DOI":"10.3390\/diagnostics16030443","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T14:12:46Z","timestamp":1770041566000},"page":"443","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Extreme Metabolic Alkalosis Caused by Temporary Jejunostomy\u2014A Case Report and Physiopathological Insights"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-4728-1839","authenticated-orcid":false,"given":"Narcis-Valentin","family":"T\u0103nase","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Clinic of Anaesthesia and Intensive Care Medicine, Dr. Carol Davila Central University and Emergency Military Hospital, 010825 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u0218tefan-Antoniu","family":"Aionese","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrei","family":"T\u0103nase","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5250-9219","authenticated-orcid":false,"given":"Luana-Maria","family":"Gherasie","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Carol Davila University of Medicine and Pharmacy, 05047 Bucharest, Romania"},{"name":"Department of Otorhinolaryngology, \u201cProf. Dr. Dorin Hociota\u201d Institute of Phonoaudiology and E.N.T. Functional Surgery, 061344 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1097\/00003246-198012000-00005","article-title":"Incidence of metabolic alkalemia in hospitalized patients","volume":"8","author":"Hodgkin","year":"1980","journal-title":"Crit. Care Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1186\/cc13802","article-title":"Metabolic alkalosis is the most common acid\u2013base disorder in ICU patients","volume":"18","author":"Haug","year":"2014","journal-title":"Crit. Care"},{"key":"ref_3","first-page":"e12841","article-title":"Pathophysiology, Evaluation, and Management of Metabolic Alkalosis","volume":"13","author":"Tinawi","year":"2021","journal-title":"Cureus"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1053\/j.ajkd.2021.12.016","article-title":"Metabolic Alkalosis Pathogenesis, Diagnosis, and Treatment: Core Curriculum 2022","volume":"80","author":"Do","year":"2022","journal-title":"Am. J. Kidney Dis."},{"key":"ref_5","unstructured":"Sur, M., and Hashmi, M.F. (2025). Alkalosis. StatPearls [Internet], StatPearls Publishing."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.bjae.2023.01.002","article-title":"Metabolic alkalosis and mixed acid\u2013base disturbance in anaesthesia and critical care","volume":"23","author":"Park","year":"2023","journal-title":"BJA Educ."},{"key":"ref_7","unstructured":"Naha, K., and Naha, S. (2017, January 1\u20134). 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Nephrol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Malbrain, M.L., Wong, A., Nasa, P., and Ghosh, S. (2024). Acid-base homeostasis: Traditional approach. Rational Use of Intravenous Fluids in Critically Ill Patients, Springer.","DOI":"10.1007\/978-3-031-42205-8"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/3\/443\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T14:29:54Z","timestamp":1770042594000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/3\/443"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,1]]},"references-count":14,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["diagnostics16030443"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16030443","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,1]]}}}