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The Korean Journal of Medicine 2009;76(6): 764-768.
정위성인공방광대치술 후 발생한 심한 대사성 산증 1예
홍성호, 이동훈, 안병무, 오숙의, 김진경, 이영기, 노정우
A case of severe metabolic acidosis after orthotopic neobladder replacement
Sung-Ho Hong, Dong Hun Lee, Byung Moo Ahn, Sook Eui Oh, Jin Kyung Kim, Young Ki Lee, Jung Woo Noh
ABSTRACT
Following a radical cystectomy to treat bladder cancer, the ureters can be implanted in a short loop of ileum, which serves as an orthotopic bladder replacement. However, several investigators have reported the frequent development of a normal anion gap metabolic acidosis and electrolyte disturbance in these patients. The colon segments secrete sodium and bicarbonate ions and reabsorb ammonium, hydrogen, and chloride ions when exposed to urine, causing metabolic acidosis. In most cases, the acid-base disorder is not very troublesome. The metabolic acidosis can usually be corrected by administering sodium bicarbonate. We experienced a case of severe metabolic acidosis associated with urinary diversion that improved with continuous renal replacement therapy (CRRT).
Keywords: Acidosis; Urinary bladder; Bicarbonates
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