Acute hyperglycemia following intraperitoneal irrigation with 10% dextrose in a patient with pseudomyxoma peritonei

Gynecologic Oncology
W J RoyI R Horowitz

Abstract

Pseudomyxoma peritonei is a condition characterized by the production of large amounts of mucopolysaccharide by a neoplastic epithelium. Although surgical debulking and removal of the mucinous ascites may be attempted, complete removal of the material is often impossible. Intraperitoneal lavage with 10% dextrose in water (D10W) has been advocated to prevent reaccumulation of the mucus and complications such as bowel obstruction requiring repeat laparotomy. We describe a patient undergoing operation for a large abdominopelvic mass. At laparotomy, a mucinous cystadenocarcinoma of the ovary was found with a great deal of tenacious, mucinous ascites and peritoneal implants. In an effort to more efficiently remove the mucus and prevent subsequent reaccumulation, intraperitoneal irrigation with 10% dextrose in water (D10W) was performed. The patient, who gave no history of prior glucose intolerance, was soon thereafter found to be profoundly hyperglycemic (serum glucose >500 mg/dl). She was treated with insulin and recovered without evident sequelae. Practitioners should be aware of this potentially dangerous complication associated with intraperitoneal dextrose instillation.

References

Jan 1, 1988·JPEN. Journal of Parenteral and Enteral Nutrition·M E PessaT G Baumgartner
Aug 1, 1981·Southern Medical Journal·M HaidT A Victor

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Citations

Oct 22, 1998·The British Journal of Surgery·F L Hinson, N S Ambrose
Jul 12, 2013·International Journal of Cancer. Journal International Du Cancer·Krishna PillaiDavid L Morris
Aug 29, 2007·Clinical Journal of Oncology Nursing·Carol BrueggenAllison Meisheid
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Feb 24, 2012·Investigational New Drugs·Krishna PillaiDavid L Morris
Sep 17, 2019·Journal of Child Sexual Abuse·Tali Gur Bustnay

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