Lactic Acidosis and Inferior Epigastric Artery Hemorrhage Complicating Alcohol-Associated Cirrhosis and Pancreatic Diabetes: A Case Report
Abstract
A woman in her 50s with alcohol-associated cirrhosis and pancreatic diabetes presented with disorientation, hypotension, coagulopathy, a plasma glucose level of 1,626 mg/dL, and severe lactic acidosis (lactate ＞30 mmol/L) after alcohol consumption and self-discontinuation of insulin. High-volume fluid resuscitation, vasopressors, continuous insulin infusion, and blood transfusion improved the metabolic derangements; however, she subsequently developed an inferior epigastric artery hemorrhage (IEAH), which required emergency transcatheter arterial embolization. IEAH can be fatal in critically ill patients with coagulopathy, necessitating prompt imaging and immediate life-saving treatment. Multidisciplinary comprehensive care is indispensable to ensure strict alcohol abstinence and thus prevent a relapse.
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BibTeX
@article{kawahara2026lactic,
title = {{Lactic Acidosis and Inferior Epigastric Artery Hemorrhage Complicating Alcohol-Associated Cirrhosis and Pancreatic Diabetes: A Case Report}},
author = {Kazuhiro Kawahara and Nozomi Harai and Atsushi Sato and Yuya Suzuki and Takayasu Uchida and Kimio Matsumura and Kaoru Nagasawa and Shunya Goto and Shigeki Yamamoto and Tomoya Tanishima and Reiko Yasui and Norio Akuta and Yasumichi Mori},
journal = {Internal Medicine},
year = {2026},
month = sep,
doi = {10.2169/internalmedicine.8161-26},
url = {https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_8161-26/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Lactic Acidosis and Inferior Epigastric Artery Hemorrhage Complicating Alcohol-Associated Cirrhosis and Pancreatic Diabetes: A Case Report
AU - Kazuhiro Kawahara
AU - Nozomi Harai
AU - Atsushi Sato
AU - Yuya Suzuki
AU - Takayasu Uchida
AU - Kimio Matsumura
AU - Kaoru Nagasawa
AU - Shunya Goto
AU - Shigeki Yamamoto
AU - Tomoya Tanishima
AU - Reiko Yasui
AU - Norio Akuta
AU - Yasumichi Mori
PY - 2026
DA - 2026/09/22
JO - Internal Medicine
DO - 10.2169/internalmedicine.8161-26
UR - https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_8161-26/_article
AB - A woman in her 50s with alcohol-associated cirrhosis and pancreatic diabetes presented with disorientation, hypotension, coagulopathy, a plasma glucose level of 1,626 mg/dL, and severe lactic acidosis (lactate ＞30 mmol/L) after alcohol consumption and self-discontinuation of insulin. High-volume fluid resuscitation, vasopressors, continuous insulin infusion, and blood transfusion improved the metabolic derangements; however, she subsequently developed an inferior epigastric artery hemorrhage (IEAH), which required emergency transcatheter arterial embolization. IEAH can be fatal in critically ill patients with coagulopathy, necessitating prompt imaging and immediate life-saving treatment. Multidisciplinary comprehensive care is indispensable to ensure strict alcohol abstinence and thus prevent a relapse.
SN - 1349-7235
SN - 0918-2918
ER -