Hypernatremia After Hypertonic Saline Irrigation of an Hepatic Hydatid Cyst

Gage, Thomas P.; Vivian, Gail

doi:10.7326/0003-4819-101-3-405_1

Cited by 17 publications

(7 citation statements)

References 3 publications

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“…While the use of agents such as formalin and silver nitrate is generally associated with the risk of acidosis and sclerosing cholangitis, the danger of hypernatraemia after cyst sterilization with hypertonic saline is not widely acknowledged. While severe hypernatraemia has been reported in the English literature only in a few cases after such treatment [12,[15][16][17][18][19][20], fatal outcomes, as in the present case, have been reported in two of these cases [17,20].…”

Section: Discussionmentioning

confidence: 69%

“…Additionally, close intra-and postoperative monitoring of electrolyte level is imperative [16]. Clearly this did not occur in our case.…”

Section: Discussionmentioning

confidence: 74%

“…Hypernatraemia may occur after absorption of hypertonic saline through the cyst wall, from the gastrointestinal tract via cyst communication with the biliary tree, from spillage of hypertonic saline in the peritoneum, or inadvertent injection of a hepatic blood vessel [16]. Severe hypernatraemia causes extracellular fluid volume expansion and intracellular fluid volume reduction, resulting in pulmonary oedema and cerebral dehydration, with convulsions and coma being a frequent sequel.…”

Section: Discussionmentioning

confidence: 98%

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Fatal hypernatraemia after laparoscopic treatment of hydatid liver cyst: Medical and legal concerns of a rare complication

Michalodimitrakis

Nathena

Mavroforou

et al. 2012

Forensic Science International

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Section: Discussionmentioning

confidence: 69%

“…Additionally, close intra-and postoperative monitoring of electrolyte level is imperative [16]. Clearly this did not occur in our case.…”

Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 98%

See 1 more Smart Citation

Fatal hypernatraemia after laparoscopic treatment of hydatid liver cyst: Medical and legal concerns of a rare complication

Michalodimitrakis

Nathena

Mavroforou

et al. 2012

Forensic Science International

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“…These agents can be used with different concentrations and exposure times. However, none of these agents can be safely used, because most have unacceptable side-effects, such as toxicity, sclerosaning cholangitis, bile duct stricture, and hypernatremia [3,[13][14][15][17][18][19][20][21]. Hypertonic saline has been used as a scolicidal agent in various concentrations (3-30%) for 50 years.…”

Section: Discussionmentioning

confidence: 99%

Octenidine Hydrochloride in Hydatid Disease

Altındiş

Arıkan

Çetınkaya

et al. 2004

Journal of Investigative Surgery

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Hydatid disease is still endemic in many devoloping countries and continues to be an important cause of morbidity. The objective of this study was to determine the in vitro scolicidal effects of octenidine hydrochloride in different concentrations using different exposure times. After hydatid cyst liquid was left to precipitate for 1 h to obtain cystic sand, various concentrations of octenidine (undiluted, 1% and 0.1% diluted) were added to concentrated hydatid cyst sediments for 5, 10, 15, 20, 25, 30, 45, and 60 min, and scolicidal effects of octenidine were compared with 20% saline and control group for the same times. It was found that undiluted octenidine had a strong scolicidal effect at 15 min compared to saline at 20%. One percent octenidine had a scolicidal effect at 30 min. However, 0.1% octenidine did not have enough scolicidal effect in 1 h. It was concluded that undiluted and 1% diluted octenidine might be used for scolicidal purpose in the treatment of hydatid disease.

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“…[87][88][89] Iatrogenic hospital-acquired hypernatremia has also been reported with use of hypertonic saline in gastric lavage and hypertonic saline-soaked wound packs for gas gangrene. 90,91 There are also several reports of accidental or nonaccidental acute salt poisoning and extreme hypernatremia, due to massive ingestion of table salt or use of salt or hypertonic saline as an emetic.…”

Section: Sodium Overloadmentioning

confidence: 99%

Les troubles de l’équilibre hydrosodé chez les patients hospitalisés

Bagshaw

Townsend

McDermid

2008

Can J Anesth/J Can Anesth

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Purpose To review and discuss the epidemiology, contributing factors, and approach to clinical management of disorders of sodium and water balance in hospitalized patients. Source An electronic search of the MEDLINE, Embase, and Cochrane Central Register of Controlled Trials databases and a search of the bibliographies of all relevant studies and review articles for recent reports on hyponatremia and hypernatremia with a focus on critically ill patients. Principal findings Disorders of sodium and water balance are exceedingly common in hospitalized patients, particularly those with critical illness and are often iatrogenic. These disorders are broadly categorized as hypo-osmolar or hyper-osmolar, depending on the balance (i.e., excess or deficit) of total body water relative to total body sodium content and are classically recognized as either hyponatremia or hypernatremia. These disorders may represent a surrogate for increased neurohormonal activation, organ dysfunction, worsening severity of illness, or progression of underlying chronic disease. Hyponatremic disorders may be caused by appropriately elevated (volume depletion) or inappropriately elevated (SIADH) arginine vasopressin levels, appropriately suppressed arginine vasopressin levels (kidney dysfunction), or alterations in plasma osmolality (drugs or body cavity irrigation with hypotonic solutions). Hypernatremia is most commonly due to unreplaced hypotonic water depletion (impaired mental status and/or access to free water), but it may also be caused by transient water shift into cells (from convulsive seizures) and iatrogenic sodium loading (from salt intake or administration of hypertonic solutions). Conclusion In hospitalized patients, hyponatremia and hypernatremia are often iatrogenic and may contribute to serious morbidity and increased risk of death. These disorders require timely recognition and can often be reversed with appropriate intervention and treatment of underlying predisposing factors.

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Hypernatremia After Hypertonic Saline Irrigation of an Hepatic Hydatid Cyst

Cited by 17 publications

References 3 publications

Fatal hypernatraemia after laparoscopic treatment of hydatid liver cyst: Medical and legal concerns of a rare complication

Fatal hypernatraemia after laparoscopic treatment of hydatid liver cyst: Medical and legal concerns of a rare complication

Octenidine Hydrochloride in Hydatid Disease

Les troubles de l’équilibre hydrosodé chez les patients hospitalisés

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