A 26 year old man with severe abdominal pain, on background of excess alcohol intake presents withMild hypotension and tachycardia

A gas which reveals:

Mixed metabolic alkalosis and respiratory acidosis

(hypochloraemic hypokalaemic metabolic alkalosis)

expected CO2 for full compensation is 53, actual is 66 (note venous gas) with mild hyponatraemia and severe hypokalaemia and hypochloraemia

Causes include dehydration, vomiting, possible ++antacid use, RTA (additional) with hypoventilation from AMS, opiates, respiratory issues

Underlying causes include gastritis, pancreatitis, bowel obstruction/ perforation, gastric outlet obstruction (a bit young) etc.

Renal failure