Dilutional hyponatraemia: A cause of massive fatal intraoperative cerebral oedema in a child undergoing renal transplantation

被引:18
作者
Armour, A [1 ]
机构
[1] INST FORENS MED,STATE PATHOLOGISTS DEPT,BELFAST,ANTRIM,NORTH IRELAND
关键词
cerebral oedema; operation; intravenous fluids;
D O I
10.1136/jcp.50.5.444
中图分类号
R36 [病理学];
学科分类号
100104 ;
摘要
A four year old boy with polyuric renal failure resulting from recurrent urinary tract infections and vesicoureteric reflux from birth underwent renal transplantation. In the past he had had five ureteric reimplant operations and a gastrostomy, as he ate nothing by mouth. He required peritoneal dialysis 13 hours a night, six nights a week. His fluid requirements were 2100 ml per day. This included a night feed of 1.5 litres Nutrizon. Before operation he received 900 ml of Dioralyte instead of the Nutrizon feed, and peritoneal dialysis was performed as usual. The operation itself was technically difficult and there was more blood loss than anticipated, requiring intravenous fluids and blood. The operation ended about four hours later but he did not wake up, Urgent computed tomography revealed gross cerebral oedema. He died the next day. At necropsy the brain was massively oedematous and weighed 1680 g.
引用
收藏
页码:444 / 446
页数:3
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