Severe Hypernatremia During Hydatid Cyst Surgery: An Anusual Cause Of Acute Abdomen  : Severe Hypernatremia During Hydatid Cyst Surgery

Mohamed Ali Chaouch; Sadok Ben Jabra; Mouna Sayadi; Omar Toumi; Faouzi Noomen

doi:10.17420/ap6903/4.515

Authors

Mohamed Ali Chaouch General and Digestive Surgery Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
Sadok Ben Jabra General and Digestive Surgery Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia https://orcid.org/0009-0006-7997-3949
Mouna Sayadi Department of Pharmacy, Fattouma Bourguiba University Hospital, Monastir, Tunisia
Omar Toumi General and Digestive Surgery Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia https://orcid.org/0000-0002-5777-5881
Faouzi Noomen General and Digestive Surgery Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia https://orcid.org/0009-0002-2217-4629

DOI:

https://doi.org/10.17420/ap6903/4.515

Abstract

Treatment of liver hydatid cysts is still in most cases surgical. To avoid the recurrence of hydatid cysts injection of scolicidal products inside the cystic cavity is an important step in the surgical procedure. Many scolicidal solutions are used. Hypertonic Saline Solution (HSS) is widely used by surgeons; however, there is a risk of hypertonic saline resorption and acute hypernatremia. Iatrogenic hypernatremia can be life-threatening. We report three cases of hypernatremia secondary to HSS injection for hydatid cyst disease treatment. The objective of this study was to discuss the clinical features, and treatment of this rare complication.

References

Zeng R., Wu R., Lv Q., Tong N., Zhang Y. 2017. The association of hypernatremia and hypertonic saline irrigation in hepatic hydatid cysts: a case report and retrospective study. Medicine 96(37): e7889. https://doi.org/10.1016/10.1097/md.0000000000007889

Michalodimitrakis M., Nathena D., Mavroforou A., Papavdi A., Kranioti E.F. 2012. Fatal hypernatraemia after laparoscopic treatment of hydatid liver cyst: medical and legal concerns of a rare complication. Forensic Science International 219(1–3): e16–18.

Muhsin S.A., Mount D.B. 2016. Diagnosis and treatment of hypernatremia. Best Practice and Research Clinical Endocrinology and Metabolism 30(2):189–203.

WHO Informal Working Group. 2003. International classification of ultrasound images in cystic echinococcosis for application in clinical and field epidemiological settings. Acta Tropica 85(2): 253–261. https://doi.org/10.1016/10.1016/s0001-706x(02)00223-1

Toumi O., Noomen F., Salem R., Rabeh H., Jabra S.B., Korbi I., Bannani S., Nasr M., Zouari K., Mondher G., Hamdi A. 2017. Intraperitoneal rupture of hydatid cysts. European Journal of Trauma and Emergency Surgery 43(3): 387–391. https://doi.org/10.1016/10.1007/s00068-016-0662-9

Albi A., Baudin F., Matmar M., Archambeau D., Ozier Y. 2002. Severe hypernatremia after hypertonic saline irrigation of hydatid cysts. Anesthesia and Analgesia 95(6): 1806–1808, table of contents. https://doi.org/10.1016/10.1097/00000539-200212000-00062

Wen H., Vuitton L., Tuxun T., Li J., Vuitton D.A., Zhang W., McManus D.P. 2019. Echinococcosis: advances in the 21st century. Clinical Microbiology Reviews 32(2): e00075-18. https://doi.org/10.1016/10.1128/cmr.00075-18

Conde M.P., Rodríguez M., López J.M., González- Porras J.R. 2015. Thrombosis secondary to acute hypernatraemia after liver hydatid cyst surgery. Blood Coagulation and Fibrinolysis 26(6): 695–698.

Krige J.E., Millar A.J., Rode H., Knobel D. 2002. Fatal hypernatraemia after hypertonic saline irrigation of hepatic hydatid cysts. Pediatric Surgery International 18(1): 64–65. https://doi.org/10.1016/10.1007/s003830200015

Anta D., Beleña J.M., Álvarez R., Núñez M. 2017. Effects of pneumoperitoneum on severe hypernatremia in an adult patient who underwent laparoscopic surgery of hydatid cysts. Journal of Clinical Anesthesia 37: 52–54. https://doi.org/10.1016/10.1016/j.jclinane.2016.10.035

Jerraya H., Khalfallah M., Osman S.B., Nouira R., Dziri C. 2015. Predictive factors of recurrence after surgical treatment for liver hydatid cyst. Surgical Endoscopy 29(1): 86–93. https://doi.org/10.1016/10.1007/s00464-014-3637-0

AlOrainy I.A., O’Gorman A.M., Decell M.K. 1999. Cerebral bleeding, infarcts, and presumed extrapontine myelinolysis in hypernatraemic dehydration. Neuroradiology 41(2): 144–146. https://doi.org/10.1016/10.1007/s002340050721

Rogers D., Tripp J., Bentovim A., Robinson A., Berry D., Goulding R. 1976. Non-accidental poisoning – an extended syndrome of child abuse. British Medical Journal (1): 793–796.

Sonani B., Naganathan S., Al-Dhahir M.A. 2021. Hypernatremia. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2021.

Severe Hypernatremia During Hydatid Cyst Surgery: An Anusual Cause Of Acute Abdomen