Acute hyperglycemia following intraperitoneal irrigation with 10% dextrose in a patient with pseudomyxoma peritonei.
Pseudomyxoma peritonei is a condition characterized by the production of large amounts of mucopolysaccharide by a neoplastic epithelium. Although surgical debulking and removal of the mucinous ascites may be attempted, complete removal of the material is often impossible. Intraperitoneal lavage with 10% dextrose in water (D10W) has been advocated to prevent reaccumulation of the mucus and complications such as bowel obstruction requiring repeat laparotomy. We describe a patient undergoing operation for a large abdominopelvic mass. At laparotomy, a mucinous cystadenocarcinoma of the ovary was found with a great deal of tenacious, mucinous ascites and peritoneal implants. In an effort to more efficiently remove the mucus and prevent subsequent reaccumulation, intraperitoneal irrigation with 10% dextrose in water (D10W) was performed. The patient, who gave no history of prior glucose intolerance, was soon thereafter found to be profoundly hyperglycemic (serum glucose >500 mg/dl). She was treated with insulin and recovered without evident sequelae. Practitioners should be aware of this potentially dangerous complication associated with intraperitoneal dextrose instillation.
Roy
W J
WJ
Department of Obstetrics and Gynecology, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
Thomas
B L
BL
Horowitz
I R
IR
D000208:Acute Disease; D000368:Aged; D003536:Cystadenocarcinoma / Q000601:surgery; D005260:Female; D005947:Glucose / Q000009:adverse effects*; D006801:Humans; D006943:Hyperglycemia / Q000139:chemically induced*; D007431:Intraoperative Complications / Q000139:chemically induced*; D007813:Laparotomy; D009378:Neoplasms, Multiple Primary; D010051:Ovarian Neoplasms / Q000601:surgery; D010533:Peritoneal Lavage; D010534:Peritoneal Neoplasms / Q000628:therapy*; D011553:Pseudomyxoma Peritonei / Q000628:therapy*
D005947:Glucose