title: Effects of pneumoperitoneum on severe hypernatremia in an adult patient who underwent laparoscopic surgery of hydatid cysts.
abstract: We describe the first case of severe hypernatremia associated to laparoscopic surgery for hydatid cyst in an adult patient after the use of hypertonic saline solution with complete resolution. Severe hypernatremia is an unusual fact at the immediate postoperative period but may have fatal consequences for the patient and need immediate action. The patient reached a serum sodium concentration of 179 mmol/L without adverse effects after 6 days of treatment. Laparoscopy could play a crucial role in Na+absorption due to high intraabdominal pressure caused by the pneumoperitoneum and its limitations to avoid peritoneal absorption of hypertonic saline solution. The relation between this surgical technique and the severe complication is discussed. More experience is needed in terms of safety for the patient.
authors.affiliation: Sureste University Hospital, Ronda del Sur 10, Arganda del Rey, Madrid. Electronic address: diego.anta@salud.madrid.es.
authors.forename: Diego
authors.initials: D
authors.lastname: Anta
authors.affiliation: Sureste University Hospital, Ronda del Sur 10, Arganda del Rey, Madrid.
authors.forename: José M
authors.initials: JM
authors.lastname: Beleña
authors.affiliation: Sureste University Hospital, Ronda del Sur 10, Arganda del Rey, Madrid.
authors.forename: Raquel
authors.initials: R
authors.lastname: Álvarez
authors.affiliation: Ramon y Cajal University Hospital, Ctra. Colmenar km 9, 100, Madrid.
authors.forename: Mónica
authors.initials: M
authors.lastname: Núñez
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis / Q000379:methods; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D004443:Echinococcosis / Q000000981:diagnostic imaging / Q000601:surgery*; D004444:Echinococcosis, Hepatic / Q000000981:diagnostic imaging / Q000601:surgery*; D004809:Ephedrine / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000627:therapeutic use; D005947:Glucose / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage / Q000627:therapeutic use; D006943:Hyperglycemia / Q000097:blood / Q000188:drug therapy; D006955:Hypernatremia / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007038:Hypotonic Solutions / Q000008:administration & dosage / Q000627:therapeutic use; D007262:Infusions, Intravenous; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009123:Muscle Hypotonia / Q000188:drug therapy / Q000209:etiology; D010149:Postoperative Pain / Q000188:drug therapy; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects*; D011184:Postoperative Period; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage / Q000009:adverse effects*; D012964:Sodium / Q000008:administration & dosage / Q000627:therapeutic use; D014662:Vasoconstrictor Agents / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D000701:Analgesics, Opioid; D007004:Hypoglycemic Agents; D007038:Hypotonic Solutions; D007328:Insulin; D012462:Saline Solution, Hypertonic; D014662:Vasoconstrictor Agents; D012964:Sodium; D004809:Ephedrine; D005947:Glucose; D005283:Fentanyl; D006854:Hydrocortisone