Published online: December 21, 2011
Question: A 73-year-old man without medical history was admitted to the Intensive Care Unit (ICU) for shock. The day before ICU admission, he suddenly experienced nausea and abdominal pain, and vomited twice. On admission, core temperature was 37.9°C, heart rate was 86 beats/min, and blood pressure was 70/36 mmHg. Painful abdominal distension without occlusion was noticed. Arterial blood gases on room air showed: pH, 7.19; HCO3−, 9 mmol/L; PaCO2, 24 mmHg; PaO2, 105 mmHg; lactate, 9.3 mmol/L. Blood work showed: glycemia, 21.4 mmol/L; creatininemia, 306 μmol/L; hemoglobin, 16 g/dL; leukocytes, 9.4 g/L; platelets, 153 g/L; alanine aminotransferase, 412 IU/L; aspartate aminotransferase, 204 IU/L; lactate dehydrogenase, 1586 IU/L; alkaline phosphatase, 111 IU/L; total bilirubin, 42 μmol/L, and lipase, 1502 IU/L.