Dilek MEMİŞ, Barış TÜKENMEZ, Zafer PAMUKÇU

Kist hidatik cerrahi girişiminde hipertonik NaCI solüsyon kullanımına bağlı hipernatremi (Olgu sunumu)

Hypernatremia due to hypertonic solution usage during cyst hydatic surgery (Case report)

Hydatic cyst, is a disease in human body made by a parasite echinococcus granulosus and % 60-80 percent settles in liver. This pathologic situation can only treated by surgical metods. One of treatment method is, ending the viability of the cyst via injecting a scolosidal substance into the cyst. For this purpose, different agents are being used, one of the most common substance which is being used is hypertonic sodium chlorid solution. It has been reported that sudden hypernatremia caused by injection of hypertonic saline solution is followed by reversible or irreversible coma. In this case report; we aimed to present hypernatremia and death which occured due to the use of hypertonic sodium chlorid solution in surgical approach of a hydatic cyst which has ruptured into the peritoneal cavity.

PDF

___

1. Engin A: Genel cerrahi tanı ve tedavi ilkeleri. 1. Baskı, Ankara: Atlas Kitapçılık Ltd Şti; 2000; 607-8.
2. Shwartz SI: Liver, “Principles of Surgery” Schwartz SI, Shires GT, Spencer FC, Daly JM, Fischer JE, Galloway AC (eds), 7.ed, Mc Graw-Hill Book Company, International Ed, 1999; 2:1403-5.
3. Rakic M, Vegan B, Sprung J, ve ark: Acute hyperosmolar coma complicating anesthesia for hydatid disease surgery. Anesthesiology 1994; 80:1175-8.
4. Wanninayake HM, Brough W, Bullock N, Calne RY, Farman JV: Hypernatraemia after treatment of hydatid. Br Med J 1982; 1(284):1302-3.
5. Reches A, Beyth Y, Melamed E, Silverberg R: Reversible hypernatremic coma following therapeutic abortion with hypertonic saline. Harefuah 1975; 1:209-11.
6. Dobato JL, Barriga FJ, Pareja JA, Vela L: Extrapontine myelinolyses caused by iatrogenic hypernatremia following rupture of a hytadid cyst of the liver with an amnesic syndrome as sequela. Rev Neurol 2000; 31:1033-5.
7. Young RS, Truax BT: Hypernatremic hemorrhagic encephalopathy. Ann Neurol 1979; 5:588-91.
8. Sayek I, Yalin R, Sanac Y: Surgical treatment of hydatid disease of the liver. Arch Surg 1980; 115:847-50.
9. Pilbeam SP: Mekanik Ventilasyon Fizyolojik ve Klinik Uygulamalar. Çeviri. Çelik M, Yalman A, Besler MP ve ark. 3. baskı. St Louis: Mosby; 1998; p.158.
10. Palevsky PM: Water and Tonicity Homeostasis. In. Carlson RW, Geheb MA (eds) Principles and Practice of Medical Intensive Care. WB Saunders Company, Philadelphia, Pennsylvania, 1993; 1168-96.
11. Bongard FS, Sue DY: Current Critical Care Diagnosis and Treatment. 1st ed. USA: Appleton&Lange; 1994; p.307-11.
12. Teres J, Gomez-Moli J, Bruguera M: Sclerosing cholangitis after surgical treatment of hepatic echinococcal cysts: Report of 3 cases. Am J Surg 1984; 147:694-97.
13. Schwartz SS, Horwitz DL: Use of a glucose controlled insulin infusion system (artificial beta cell) to control diabetes during surgery. Diabetologia 1979; 16:157-64.