D-Lactic Acidosis in a Man with the Short-Bowel Syndrome

WE have recently studied a patient who had short-bowel syndrome that presented with peculiar neurologic manifestations and severe metabolic acidosis. The anion gap was increased, but the identity of the abnormal anion was not readily apparent. By several chemical technics the agent responsible for metabolic acidosis was found to be D-lactic acid — a cause of metabolic acidosis familiar to veterinarians but not to physicians. Case History The patient, a 30-year-old man, was in good health until July, 1975, when a superior mesenteric-vein thrombosis of unknown cause resulted in gangrene of most of the small intestine. After emergency jejunoileostomy with.