What type of acid-base disturbance is associated with high-output uretosigmoidostomy?

High-output uretosigmoidostomy involves the surgical diversion of urine into the sigmoid colon, where the urine mixes with the colonic contents. This process can lead to significant losses of bicarbonate, an important buffer in the blood, particularly if the output is high and continuous. The loss of bicarbonate occurs because urine is rich in electrolytes, and when it is diverted to the sigmoid, it can cause a net loss of bicarbonate when absorbed across the colonic mucosa.

As bicarbonate levels in the blood decrease, the body becomes more acidic, resulting in metabolic acidosis. This type of acid-base disturbance reflects an accumulation of acids or a loss of bicarbonate, both of which are possible with high-output uretosigmoidostomy. Furthermore, the state can be exacerbated by diarrhea or further losses from other sources, reinforcing the development of metabolic acidosis.

Other acid-base disturbances are less likely in this context. Metabolic alkalosis, for instance, typically arises from excessive loss of acids or a gain of bicarbonate, which does not fit the scenario presented. Similarly, respiratory acidosis and respiratory alkalosis involve changes in carbon dioxide levels due to alterations in breathing, which are not directly related to a uretos