A young female presented with epigastric pain, scant vomiting and generalized weakness. Ultrasound abdomen was normal. Serum lipase and amylase were raised. Arterial blood gases (ABGs) revealed metabolic acidosis, electrocardiogram (ECG) showed U-waves, serum potassium was 2.1, urine pH and urinary sodium were 6 and 82 mEq/L respectively and urine anion gap was raised. A diagnosis of distal renal tubular acidosis and acute pancreatitis was made. She was made pain free and nil per os (NPO) was ordered. For her renal tubular acidosis she was given intravenous potassium citrate followed by sodium bicarbonate. The patient got clinically improved and was then discharged home on oral potassium citrate.
Acute pancreatitis, Hypokalemia, Renal tubular acidosis.