An unusual presentation of diabetic ketoacidosis associated with ascariasis and fungal esophagitis: A case report.

RATIONALE: Gastrointestinal symptoms are most commonly observed in patients with diabetic ketoacidosis (DKA), which usually resolves completely with therapy. However, gastrointestinal symptoms may persist after DKA is resolved. PATIENT CONCERNS: A 22-year-old female was admitted to hospital for epigastric pain and persistent vomiting. The results of laboratory examination showed fungal esophagitis complicated by DKA. DIAGNOSIS: The patient was diagnosed with DKA associated with ascariasis and fungal esophagitis. OUTCOME: The patient was discharged after treatment. LESSONS: In this case, despite the correction of metabolic acidosis, persistent nausea, vomiting and dysphagia can be a sign of esophagitis in patients with type 1 diabetes. Therefore, physicians should be aware of fungal infections associated with type 1 diabetes.

The Use of Computed Tomography in the Diagnosis of Fatty Liver and Abdominal Fat Distribution among a Saudi Population.

BACKGROUND: The pandemic of obesity is striking heavily worldwide and particularly among the affluent Gulf States where it is expected to continue to rise along with its complications. AIM: To examine the link between liver fat infiltration and abdominal fat amount using plain computer-assisted tomography (CT). METHODS: Fifty patients visiting the obesity clinic of "King Fahd Specialist Hospital" or Dr Suliman Alhabeeb Hospital between January 2015 and April 2016 were included. Liver and splenic attenuation dimensions were undertaken with three hepatic regions of interests (ROIs) and two ROIs from the spleen. The liver attenuation indices (LAIs) that were measured liver parenchymal attenuation (CTLP), liver/splenic attenuation ratio (LS ratio)and the (3) difference between liver and splenic attenuation (LS dif) and based on this LS dif The patients were grouped as LS dif greater or less than 5. Abdominal fat was evaluated utilising a 3 mm chop CT scan starting from the umbilicus; then computed by a workstation. The abdominal fat was classified as total fat (TF) and the sub-compartments of visceral adipose (fat) (VF), and subcutaneous fat (SF). RESULTS: Twenty-six of the participants were males. The mean (SD) of the age and BMI was 48 (14.9) years and 32.05 (8.3) kg/m2 respectively. The BMI and body Wt had a moderate negative correlation with the liver attenuation indices CTLP, LS ratio, LS diff (r = -0.417, -0.277, -0.312 and 0.435, -0.297, -0.0297), respectively. A very strong negative correlation between fatty liver, LS ratio and CTLP was found (-0.709, -0.575) respectively. CONCLUSION: Plain computed tomography can reliably be used as a survey device for fatty liver disease.