Diabetic ketoacidosis (DKA) is a medical emergency characterized by hyperglycemia, high anion gap metabolic acidosis and elevated circulating ketone bodies resulting from severe impairment of insulin secretion and/or action. Besides dehydration, nausea and vomiting, abdominal pain is also considered to be a cardinal clinical feature of DKA. Diagnosis relies on biochemical criteria, and disease severity on clinical and laboratory findings. Radiological investigation is not standard of care of DKA despite being required in specific situations. The authors report on a case of a patient with DKA and abdominal pain, whose investigation revealed chronic pancreatitis and a massive splenic artery pseudoaneurysm. The case is remarkable for the rarity of the clinical entity and reminds the clinician to the importance of imaging in newly diagnosed diabetes.

Doente do sexo feminino, com 67 anos de idade, recorre ao Serviço de Urgência por lombalgia bilateral com irradiação abdominal, anorexia e edema dos membros inferiores.O quadro tem início no mês anterior, após internamento por desidratação secundária a diarreia crónica iatrogénica. [...]