Kewei Li1, Yijun Liu2, Xiaolong Xie1, Rongxing Zhou3, Bo Xiang4. 1. Department of Pediatric Surgery, West China Hospital of Sichuan University, 610041, Chengdu, China. 2. West China School of Medicine of Sichuan University, Chengdu, China. 3. Department of biliary surgery, West China Hospital of Sichuan University, Chengdu, China. 4. Department of Pediatric Surgery, West China Hospital of Sichuan University, 610041, Chengdu, China. xb_edu_2116@163.com.
Abstract
BACKGROUND: Using effective scolicidal agents intraoperatively is essential to lessen the recurrence rate of hepatic echinococcosis. However, severe hypernatremia may occur after hypertonic saline (HS) has been applied as the scolicidal agent. The aim of this study is to report on pediatric patients with severe hypernatremia after hepatic echinococcus surgery. METHODS: Patients who presented to West China Hospital between January 2010 and February 2017 were retrospectively analyzed. Children under 16 years with echinococcosis treated by resection were included in the study. RESULTS: A total of 26 children were enrolled in this study, including 16 boys and 10 girls with a median age of 8 (2-16). 24 (92.3 %) cases were cystic echinococcosis (CE) and two (7.7 %) were alveolar echinococcosis (AE). According to Clavien-Dindo classification of surgical complications, the complication rate of all 26 patients was 19.2 %, among which three cases belonged to Grade I, one to Grade III b and 1 to Grade IV. Two children encountered severe hypernatremia (sodium: 155.3 mmol/L and 190.0mmol/L). Data showed classic clinical features of severe hypernatremia: profound and persistent bradycardia, hypotension and coma. After treatment, they recovered well without any neurologic sequelae. All patients were followed up regularly for a median time of 38 months (range 4-89 months); the overall disease-free survival was 100.0 %. CONCLUSIONS: HS irrigation of intra-abdominal echinococcosis may cause acute hypernatremia and severe consequences. Diagnostic suspicion and early intervention are vital tools for avoiding morbidity and mortality.
BACKGROUND: Using effective scolicidal agents intraoperatively is essential to lessen the recurrence rate of hepatic echinococcosis. However, severe hypernatremia may occur after hypertonic saline (HS) has been applied as the scolicidal agent. The aim of this study is to report on pediatric patients with severe hypernatremia after hepatic echinococcus surgery. METHODS:Patients who presented to West China Hospital between January 2010 and February 2017 were retrospectively analyzed. Children under 16 years with echinococcosis treated by resection were included in the study. RESULTS: A total of 26 children were enrolled in this study, including 16 boys and 10 girls with a median age of 8 (2-16). 24 (92.3 %) cases were cystic echinococcosis (CE) and two (7.7 %) were alveolar echinococcosis (AE). According to Clavien-Dindo classification of surgical complications, the complication rate of all 26 patients was 19.2 %, among which three cases belonged to Grade I, one to Grade III b and 1 to Grade IV. Two children encountered severe hypernatremia (sodium: 155.3 mmol/L and 190.0mmol/L). Data showed classic clinical features of severe hypernatremia: profound and persistent bradycardia, hypotension and coma. After treatment, they recovered well without any neurologic sequelae. All patients were followed up regularly for a median time of 38 months (range 4-89 months); the overall disease-free survival was 100.0 %. CONCLUSIONS:HS irrigation of intra-abdominal echinococcosis may cause acute hypernatremia and severe consequences. Diagnostic suspicion and early intervention are vital tools for avoiding morbidity and mortality.
Authors: Philippe Esquis; David Consolo; Guy Magnin; Philippe Pointaire; Philippe Moretto; Maria Dolores Ynsa; Jean-Luc Beltramo; Carole Drogoul; Michel Simonet; Laurent Benoit; Patrick Rat; Bruno Chauffert Journal: Ann Surg Date: 2006-07 Impact factor: 12.969
Authors: Olivier Facy; Sophie Al Samman; Guy Magnin; Francois Ghiringhelli; Sylvain Ladoire; Bruno Chauffert; Patrick Rat; Pablo Ortega-Deballon Journal: Ann Surg Date: 2012-12 Impact factor: 12.969