Fatal hypernatraemia after hypertonic saline irrigation of hepatic hydatid cysts.
A 7-year-old boy with hepatic hydatid cysts developed fatal hypernatraemia after surgery for cyst removal where 20% hypertonic saline (HS) was used as a scolicidal agent. Symptoms of generalised seizures, tachycardia, and hypotension developed within 6 h of surgery. Serum electrolytes confirmed hypernatraemia (170 mmol/l) and hyperchloraemia (141 mmol/l). Despite attempts at resuscitation, he died 20 h later. The literature is reviewed, emphasising the potential dangers of the use of HS and the clinical presentation and appropriate management of hypernatraemia.
Krige
J E J
JE
Department of Surgery, University of Cape Town, Medical School, Observatory 7925, Cape Town, South Africa.
Millar
A J W
AJ
Rode
H
H
Knobel
D
D
D002648:Child; D004444:Echinococcosis, Hepatic / Q000601:surgery*; D017809:Fatal Outcome; D006801:Humans; D006955:Hypernatremia / Q000209:etiology*; D008297:Male; D012462:Saline Solution, Hypertonic / Q000009:adverse effects*; D007507:Therapeutic Irrigation / Q000009:adverse effects*
D012462:Saline Solution, Hypertonic