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. 2020 Aug;4(3):482-484.
doi: 10.5811/cpcem.2020.6.47617.

Tubelight Adrenals in Diabetic Ketoacidosis

Prakrati Yadav  1 , Akhilesh Kumar  1 , Rohit Mathur  1 , Pawan Garg  1 , Maya Gopalakrishnan  1 , Mahendra Kumar Garg  1
Affiliations

Tubelight Adrenals in Diabetic Ketoacidosis

Prakrati Yadav et al. Clin Pract Cases Emerg Med. 2020 Aug.

Abstract

Case presentation: We report a patient with the triad of diabetic ketoacidosis, hypertriglyceridemia, and acute pancreatitis associated with computed tomography hypoperfusion complex and adrenal hyperdensity on abdominal imaging - an association not previously reported in diabetic ketoacidosis.

Discussion: Presence of computed tomography hypoperfusion complex with hyperdense 'Tubelight adrenals' in a patient with diabetic ketoacidosis is associated with poor prognosis and thus serves to guide clinicians towards early and aggressive management.

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Conflict of interest statement

Conflicts of Interest: By the CPC-EM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. The authors disclosed none.

Figures

Image
Image
Contrast-enhanced computed tomography abdomen axial (A, B) and coronal (C, D) images showing diffuse pancreatic necrosis (white arrow) with significant peripancreatic inflammation. Intense enhancing bilateral adrenal glands (dashed arrow) with mucosal hyperenhancement of small bowel loops (black arrow) and gross ascites are visible. The short white arrow indicates narrow caliber of abdominal aorta with imperceptible inferior vena cava. Bilateral kidneys (asterisks) are heterogeneously enhancing with perinephric fat stranding likely due to diabetic nephropathy.
See this image and copyright information in PMC

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