In the presence of metabolic disorders with ketoacidosis the abdominal pain may not be surgically relevant but caused by the metabolic and electrolytic disorder..........The pathogenesis of the abdominal pain arising in ketoacidosis is yet to be clarified but a combined metabolic and electrolytic origin is hypothesised.

의학 저널에는 정확하게 규명되진 않았지만, metabolic and eletrolyte disorder라고 하네요...