Postoperative Hypernatremia in Liver Hydatid Disease: a Case Report

Abstract

Hydatid cyst, frequent in sheep raising countries, is a parasitic disease caused by a cestode, Echinococcus granulosus, and is spread to man by dog feces. A hydatid cyst, 7x8 cm in diameter, located on the dome of the liver of a 48 year old male patient was removed by thoracotomy. During the surgery, some hypertonic saline solution absorbed sponges were applied to the operation site. The same solution was used inside the cyst for scolocidal effect and the intraabdominal cavity was washed with the same solution. During the postoperative period, following extubation, a generalized convulsion developed. A serum sample of the patient was sent to the laboratory for testing of the serum sodium concentration. It was 185 mEq/L. The aim of this study was the consideration of hypernatremia and related neurologic signs depending upon the use of hypertonic saline solutions in hydatid cyst surgery for scolocidal effects. Because general anesthesia conceals neurological findings of hypernatremia, the serum sodium concentration should be followed carefully during surgery.