Massive perioperative polyuria

A 25-year-old man with a spinal cord transection secondary to a gunshot wound underwent surgical repair of a perforated prepyloric ulcer on the eighth hospital day. He received 68 liters and excreted 43 liters of intravenous fluid during the perioperative period. Causes of this massive polyuria during and after the second operation are unknown, although iatrogenically induced glycosuria and natriuresis may have contributed to its severity. The problems and their management are discussed.