Central diabetes insipidus: a rare perioperative cause of severe hypernatraemia.
In this case report we describe the management of severe hypernatraemia following inadvertent water restriction. A 21-year-old woman with no reported medical history presented on transfer from an outside hospital with a complex volar upper extremity injury. Management both operatively and postoperatively involved a prolonged period of fasting which limited her access to drinking water Collateral history revealed that she had previously drunk copious amounts of water during the course of any given day and this had served to alleviate the dramatic symptoms of hypernatraemia that were rapidly manifest when her normal intake was curtailed. We outline the fluid management, administration of desmopressin and her subsequent recovery. A literature review of the management of central diabetes insipidus is also covered.
Hayanga
A J
AJ
Division of Acute Care Surgery, University of Michigan, Ann Arbor, Michigan 48109-0033, United States of America.
Kohen
R
R
Egeland
B
B
Charles
A
A
Spoor
M
M
Kuzon
W M
WM
Napolitano
L M
LM
D000328:Adult; D001921:Brain / Q000473:pathology; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use; D003919:Diabetes Insipidus / Q000150:complications* / Q000378:metabolism; D005260:Female; D006801:Humans; D006955:Hypernatremia / Q000209:etiology* / Q000378:metabolism; D007431:Intraoperative Complications / Q000209:etiology* / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D009994:Osmolar Concentration; D012076:Renal Agents / Q000627:therapeutic use; D012151:Resuscitation; D012964:Sodium / Q000097:blood; D013708:Tendon Injuries / Q000601:surgery
D012076:Renal Agents; D012964:Sodium; D003894:Deamino Arginine Vasopressin