• Hiroo Uchida, Hideki Yamamoto, Yoshiyuki Kisaki, Junko Fujino, Yuki Ishimaru, and Hitoshi Ikeda.
• Department of Pediatric Surgery, Dokkyo University School of Medicine, Koshigaya Hospital, Koshigaya, Japan.
• J. Pediatr. Surg. 2004 Apr 1;39(4):634-6.

AbstractD-lactic acidosis sometimes occurs in malabsorbed patients with short-bowel syndrome and is characterized by recurrent episodes of encephalopathy and metabolic acidosis. The characteristic neurologic abnormalities and the presence of metabolic acidosis raises a diagnostic suspicion, and the diagnosis is made when the serum level of D-lactic acid is greater than 3 mmol/L. Standard treatment consists of restricting oral carbohydrates or fasting, correction of metabolic acidosis, and a long-term suppression of pathogenic floras with antibiotics. The authors present a case of D-lactic acidosis in a 22-year-old patient with short-bowel syndrome, to whom intestinal bacterial agents (probiotics) were given in addition to oral kanamycin. Recolonization of the intestine with nonpathogenic floras should be a long-term treatment for D-lactic acidosis.

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