Korean Journal of Nephrology 2010;29(5):600-605.
2 Cases of Severe Hyperchloremic Metabolic Acidosis after Orthotopic Neobladder Replacement and Augmentation Enterocystoplasty
Hankyu Lee, M.D.1, Hui Kyuoung Sun, M.D.2, Dong Ki Kim, M.D.2, Kook-Hwan Oh, M.D.2, Yon Su Kim, M.D.2, Curie Ahn, M.D.2, Jin Suk Han, M.D.2, Sunhngwon Kim, M.D.2, Cheol Kwak, M.D.3, Seungjune Oh, M.D.3 and Kwon-Wook Joo, M.D.2
Department of Internal Medicine1
Eulji University College of Medicine, Department of Internal Medicine2
Seoul National University College of Medicine, Department of Urology3
Seoul National University College of Medicine
증례 : 정위 인공방광대체술 및 방광확대술 후 발생한 심한 고염소혈증 대사성 산증 2예
이한규1, 선휘경2, 김동기2, 오국환2, 김연수2, 안규리2, 한진석2, 김성권2, 곽철3, 오승준3, 주권욱2
을지대학교 의과대학 내과학교실1 , 서울대학교 의과대학 내과학교실2, 서울대학교 의과대학 비뇨기과학교실3
Abstract
The use of intestinal segments in the reconstruction and plasty of urinary bladder for malignant or nonmalignant conditions is widely accepted. Metabolic derangements including hyperchloremic metabolic acidosis and malabsorption of lipid may occur after surgery. Main pathophysiology of hyperchloremic metabolic acidosis is the exchange of urinary chloride with luminal bicarbonate and duration of urine in contact with the intestinal mucosa can affect the severity of metabolic acidosis. We experienced two cases of severe hyperchloremic metabolic acidosis which developed in patients with chronic kidney disease, urinary tract infection and orthotopic neobladder or augmentation enterocystoplasty for the treatment of bladder cancer and neurogenic bladder, respectively.
Key Words: Urinary diversion, Acidosis, Urinary bladder
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