Open Access Library Journal 2020, Volume 7, e6338 ISSN Online: 2333-9721 ISSN Print: 2333-9705 DOI: 10.4236/oalib.1106338 Aug. 18, 2020 1 Open Access Library Journal Metabolic Alkalosis Associated Fluid and Electrolyte Disorders Revealing an Upper Digestive Tract Condition Ameth Dieng 1* , M. A. Ba 1 , A. T. Lemrabott 1 , M. Diop 1 , A. Sy 1 , M. Ndongo 1 , B. Ndiaye 1 , M. S. Diawara 2 , M. Faye 1 , Mo Faye 1 , B. Ba 1 , N. Keita 1 , S. Diagne 1 , M. M. Cissé 2 1 Department of Nephrology, Dialysis and Kidney Transplant in Hospital Aristide Le Dantec, Dakar, Senegal 2 Department of Nephrology and Dialysis in Regional Hospital, Thies, Senegal Abstract We report a case of a 66-year-old female patient with ischemic cardiomyopa- thy, who was referred in Nephrology Department for the management of a renal impairment associated-severe hyponatremia, hypokalemia and hypoch- loremia that occurred after vomiting episodes evolving since 1 month. On admission, the patient was calm with a psychomotor retardation occurring in a context of moderate dehydration. Arterial blood gas analysis outlined a se- vere metabolic alkalosis. An extra-renal cause of these metabolic disorders was retained on the basis of a metabolic alkalosis not featuring an HBP and the urinary ionogram revealing low urine sodium, potassium and chlorine. The se- riousness of the clinical course was made by the underlying cardiomyopathy condition, hypocalcemia, severe consistent hypokaliemia and compensatory hypoventilation. The evolution was unremarkable after 4 days of hydro-sodium deficit correction with potassium chloride adjunction. It featured a drowsi- ness disappearance and a good temporal-spatial orientation. The clinical ex- amination revealed a good general condition associating a good hydration and hemodynamic state. The lab findings showed a normal plasma sodium levels and increased kalemia and chloremia. Upper digestive endoscopy out- lined a hiatal hernia associated-erosive bulbitis indicating an eradicator treatment of Helicobater pylori based on a double dose of PPI (Omeprazole 20 mg) and dual antibiotic therapy (Amoxicillin and Clarithromycin) com- bined with domperidone. Subject Areas Anaesthesiology & Pain Management, Cardiology, Diabetes & Endocrinology, Gastroenterology & Hepatology, Internal Medicine, Metabolic Sciences, How to cite this paper: Dieng, A., Ba, M.A., Lemrabott, A.T., Diop, M., Sy, A., Ndongo, M., Ndiaye, B., Diawara, M.S., Faye, M., Faye, M., Ba, B., Keita, N., Diagne, S. and Cissé, M.M. (2020) Metabolic Alkalosis Associated Fluid and Electrolyte Disorders Revealing an Upper Digestive Tract Condition. Open Access Library Journal, 7: e6338. https://doi.org/10.4236/oalib.1106338 Received: April 20, 2020 Accepted: August 15, 2020 Published: August 18, 2020 Copyright © 2020 by author(s) and Open Access Library Inc. This work is licensed under the Creative Commons Attribution International License (CC BY 4.0). http://creativecommons.org/licenses/by/4.0/ Open Access