Does alcoholic ketoacidosis go undetected?

• DOI: 10.1111/j.1442-2026.1995.tb00190.x
• Publication Date: 2010-08-11T10:39:24Z
• Authors: Michael Ragg; David Eddey
• Keywords: 03 medical and health sciences; 0302 clinical medicine; 3. Good health

AbstractObjectiveTo review the condition of alcoholic ketoacidosis.Data sourcesEnglish language literature search using Medline® for the period 1973 to 1993. A total of 34 articles, abstracts and book chapters were used.Data synthesisAlcoholic ketoacidosis has been recognised for over 50 years yet there seems to be a lack of knowledge about this condition. The patient usually abuses alcohol, and presents with nausea, vomiting and abdominal pain. Laboratory tests show an increased anion gap metabolic acidosis and electrolyte changes secondary to vomiting and dehydration. Urinalysis may be negative for ketones. The differential diagnosis is that of a raised anion gap metabolic acidosis in the setting of chronic alcohol consumption. Intravenous fluids and glucose are the mainstays of treatment.ConclusionAcutely unwell patients who abuse alcohol commonly present to the emergency department. Failure to consider alcoholic ketoacidosis may lead to inappropriate discharge.