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Hepatic Hypoglycemia and Infarction of the Bowel

Arch Intern Med. 1963;112(1):50-55. doi:10.1001/archinte.1963.03860010096010.
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Hepatic hypoglycemia has been recognized since 1929, but only one series records chronic passive congestion of the liver as the cause. This case report describes rheumatic heart disease with congestive failure and superimposed profound shock of 24 hours' duration. The resulting hypoglycemia is the lowest blood sugar of hepatic origin recorded in the medical literature. Infarction of the bowel without mesenteric thrombosis was responsible for the irreversible shock.

Report of a Case  A 49-year-old white woman was admitted to the hospital on Feb 15, 1962, because of abdominal pain of 24 hours' duration.

History.  —The patient had had rheumatic heart disease for 20 years. When she was first seen four months before admission, dyspnea, orthopnea, and ankle edema were present. The apical rate was 150 per minute with atrial fibrillation. Digitalis was reinstituted, an unknown quantity having previously been taken intermittently in the past. With a maintenance dose of 0.2


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