[Transient hyperglycemia following intra-peritoneal irrigation with 5% glucose in a patient with pseudomyxoma peritonei].

Abstract

Pseudomyxoma peritonei is a condition characterized by the production of a large amount of mucopolysaccharide by a neoplastic epithelium. Although surgical removal of the mucinous ascites may be attempted, complete removal of the material is difficult. Thus, intra-peritoneal lavage with the liquid containing glucose or dextrose has been advocated to prevent reaccumulation of the mucus and complications such as bowel obstruction requiring repeated surgery. We report a case showing transient hyperglycemia following intra-peritoneal irrigation with 5% glucose in a patient with psudomyxoma peritonei. The patient was a 72-year-old woman. Preoperatively, she had hypertension and angina pectoris; but no history of glucose intolerance. Serum glucose was 92 mg x dl(-1). General anesthesia was induced with propofol (100 mg), vecuronium (6 mg), and fentanyl, and maintained with oxygen (33%), nitrous oxide and sevoflurane (1-2%). A mucinous tumor was found with a great deal of mucinous ascites. To remove the mucus and prevent subsequent re-accumulation, intra-peritoneal irrigation with 5% glucose in water was performed. Shortly after this procedure, the patient was found to be hyperglycemic (serum glucose 266 mg x dl(-1)) with normal oxygenation and hemodynamic data. The patient recovered uneventfully and could be extubated soon after surgery. Serum glucose level returned to 154 mg x dl(-1) one hour after surgery. Therefore, we think that this acute hyperglycemic condition, presumable due to intra-peritoneal irrigation, was transient. It is important to be aware of this dangerous complication associated with intra-peritoneal glucose instillation. Glucose monitoring during and after irrigation with glucose or dextrose is recommended.

• Authors: Rie Mieda, Chizu Aso, Koichi Nishikawa, Shigeru Saito, Fumio Goto
• Journal: Masui. The Japanese journal of anesthesiology (Masui) Vol. 56 Issue 8 Pg. 959-61 (Aug 2007) ISSN: 0021-4892 [Print] Japan
• PMID: 17715692 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Blood Glucose
• Glucose

Topics

• Aged
• Anesthesia, General
• Blood Glucose
• Female
• Glucose (adverse effects, therapeutic use)
• Humans
• Hyperglycemia (etiology)
• Monitoring, Physiologic
• Peritoneal Lavage (adverse effects, methods)
• Postoperative Complications (etiology)
• Pseudomyxoma Peritonei (surgery)