Diagnosis of an
acute abdomen during an episode of
diabetic ketoacidosis (DKA) is crucial for providing appropriate treatments and obtaining favourable outcomes, but may be difficult due to its considerable overlap with multiple intra-abdominal diseases in terms of
clinical course and laboratory findings. In this study, we presented a case showing signs of an
acute abdomen with sharp rises in serum pancreatic
biochemical markers during the treatment of DKA with
pyelonephritis. Contrast-enhanced computed tomography (CT) was performed to confirm the onset of
acute pancreatitis; however, pneumatosis intestinalis and poor enhancement of the rectal wall were detected, indicating the presence of rectal
infarction. Hartmann's procedure was immediately performed, and histological examination of the resected specimen revealed gangrenous ischaemic
colitis. The present case highlights DKA as a risk factor of ischaemic
colitis and the role of contrast-enhanced CT in the differential diagnosis of an
acute abdomen in hyperglycaemic crisis.