Type B lactic acidosis is a rare complication of non-tissue perfusion abnormalities caused by solid tumors or hematologic malignancies. Herein, we present the case of a 42-year-old man with type B lactic acidosis and hypoglycemia who was found to have a diffuse large B-cell lymphoma. The cause of lactic acidosis and/or hypoglycemia is thought to be the Warburg effect, which is when the metabolic rate of a rapidly growing malignant tumor is very high and dominated by glycolysis. Systemic damage from type B lactic acidosis can occur when the increased rate of glycolysis exceeds the normal muscle and liver lactic acid clearance rate. The Warburg effect is a rare but serious condition that needs to be recognized, not only in diffuse large B-cell lymphoma, but also in other malignancies. The prognosis of lactic acidosis in patients with malignant tumors is very poor. Currently, effective chemotherapy seems to be the only hope for survival.

Aortic dissection is a serious acute cardiovascular disease with rapid onset, progression and a high mortality rate. Due to the range of different branching vessels involved, the clinical symptoms are complex and diverse. The typical clinical symptom is a severe tearing pain in the chest, back or abdomen, but some patients also have atypical symptoms, which are easily missed or misdiagnosed and can be life-threatening. The present study reports a case of painless type B aortic dissection, initially diagnosed as ileus. The objective of this study is to enhance the clinical understanding of painless aortic dissection so that the disease can be quickly and accurately detected, and treated in a timely manner, thereby improving patient outcomes.