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Severe Disruption of Water and Electrolyte Balance After Appendectomy

A Case Report

Bossong, Olga, MD*; Rudin, Christoph, MD; Szinnai, Gabor, MD, PhD; Erb, Thomas O., MD, MHS*; Moll, Jens, MD*

doi: 10.1213/XAA.0000000000000812
Case Reports

Perioperative derangements of fluid and electrolyte homeostasis are rare complications in healthy children. Nonetheless, early diagnosis and treatment are mandatory to avoid a potentially life-threatening situation. However, the variety of underlying pathologies may prove to make accurate diagnosis challenging. This case report presents the management of an unexpected occurrence of a perioperative partial diabetes insipidus with massive fluid loss. Diagnostic and therapeutic procedures are discussed in the context of laboratory findings, and an overview of the existing literature is given. Finally, we emphasize that a multidisciplinary approach is most appropriate for diagnosis, accurate treatment, and follow-up of the patient.

From the Departments of *Anesthesiology

Pediatric Nephrology

Pediatric Endocrinology, University Children’s Hospital Basel, Basel, Switzerland.

Accepted for publication April 30, 2018.

Funding: This case report was solely funded by the Department of Anesthesiology, University Children’s Hospital Basel.

The authors declare no conflicts of interest.

Address correspondence to Olga Bossong, MD, Department of Anesthesiology, University of Basel, University Children’s Hospital Basel, Spitalstrasse 33, P.O. Box CH-4031, Basel, Switzerland. Address e-mail to

© 2018 International Anesthesia Research Society
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