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[Iatrogenic hypernatremia during hydatid cyst operation]
Perihan Ergin Ozcan1, Ayşen Yavru, Simru Tuğrul
1Istanbul Medical School, Department of Anesthesiology, Istanbul, Turkey, pergin@istanbul.edu.tr
Summary
Severe hypernatremia (high serum sodium) can occur after hepatic hydatid cyst surgery. Careful monitoring of sodium levels is crucial, as anesthesia can mask neurological symptoms.
Area of Science:
- Medicine
- Surgery
- Anesthesiology
Background:
- Iatrogenic hypernatremia, often resulting from excessive salt administration, poses a significant clinical challenge.
- Hepatic hydatid cyst surgery involves potential risks, including electrolyte disturbances.
- General anesthesia can mask the neurological manifestations of hypernatremia.
Observation:
- A 55-year-old woman developed severe hypernatremia (serum sodium 185 mEq/L) post-operatively after hepatic hydatid cyst removal.
- The patient presented with unconsciousness following extubation, a potential neurological sign of hypernatremia.
- Hypertonic saline, used for scolecidal effects during surgery, is a likely cause of the salt gain.
Findings:
- The patient's serum sodium concentration was corrected to 142 mEq/L within 36 hours in the intensive care unit.
- Neurological status improved, and the patient regained consciousness, allowing for extubation and transfer to the ward.
- This case highlights the critical need for vigilant serum sodium monitoring in patients undergoing hepatic hydatid cyst surgery.
Implications:
- Anesthesia can obscure the early detection of hypernatremia, emphasizing the importance of proactive electrolyte monitoring.
- Healthcare providers should be aware of the risk of iatrogenic hypernatremia in surgeries utilizing hypertonic saline.
- Prompt recognition and management of hypernatremia are essential for preventing severe neurological complications.