Introduction. Short bowel syndrome (SBS) is a group of problems related to malabsorption of fluid and nutrients, occurring in people who have lost extensive segments of small bowel because of pathology or surgery. The final common etiologic factor in all causes of short-bowel syndrome is the functional or anatomic loss of extensive segments of small intestine so that absorptive capacity is severely compromised. SBS usually occur after surgery for necrotizing enterocolitis, intestinal atresia, gastroschisis, etc. The main symptoms of SBS are: diarrhea, fluid depletion, flatulence. Clinical manifestation depends on length and damage of intestine, age of the patient, location of the resection, comorbidity. The diagnosis of SBS includes anamnesis of the resection, clinical symptoms, fluid and electrolytes imbalance, malnutrition and poor weight gain.
Methods. We present case history and literature review of rare complication of short bowel syndrome - D lactic acidosis in 1 year and 11 months old girl. D-lactic acidosis (D-la) is a rare complication in patients with short bowel syndrome. D-la is associated with metabolic acidosis and acute neurologic manifestation including altered mental status and ataxia. The pathophysiology of D-la includes abnormal gastrointestinal anatomy and specific coonic bacteria. D-la occurs when excessive malabsorbed carbohydrate enters the colon and is fermented by colonic bacteria to D-lactate. Elevated concentration of D-lactate are absorbed into the circulation which results the high concentration of D-lactate in the blood. Typically clinical D-la symptoms are acute encefalophaty accompanied by tachypnea, metabolic acidosis. Although laboratory foundings confirm D-lactic acidosis, clinical manifestation of D-la still remains the most important diagnostic part of this pathology. The treatment of D-la is based on the diet and reduction of colon microbiota.
Conclusion. D lactic acidosis is a rare but serious complication of the patients with short gut syndrome and preserved colon.
