Royal College of Surgeons in Ireland
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A woman with syncope and acidosis

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posted on 2023-01-26, 17:01 authored by Adnan Ather Malik, Aran Nanthakumar, Dana Mahdi, Sai Venkatesh Alluri, Salonee Dhungana, Laura Bleehen, Charlsea Maynard, Umar Butt, Jerry Chacko, M Adam Ali

A 77-year-old-woman with poorly controlled type 2 diabetes mellitus presented with a 1-week history of anorexia and nausea. Blood tests revealed leukocytosis associated with a left shift (white cells 21,140 and neutrophil count of 17,380 per cubic millimeter) and elevation of the levels of C-reactive protein (21.0 mg/dL). In the emergency department, she collapsed. Arterial blood gas analysis revealed metabolic lactic acidosis with pH 7.23 and lactate of 13.5 mmol per liter. Abdomino-pelvic computed tomography demonstrated intramural gas of the bladder in a cobblestone pattern  



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Published Citation

Malik AA. et al. A woman with syncope and acidosis. J Am Coll Emerg Physicians Open. 2022;3(6):e12853..

Publication Date

22 November 2022

PubMed ID



  • Undergraduate Research


John Wiley & Sons, Inc.


  • Published Version (Version of Record)