Hypertonic Saline Irrigation of Ruptured Liver Hydatid Cyst: A Unique Case Report of Successful Treatment of Severe Iatrogenic Hypernatremia


  • Asiah Salem Rugaan King Abdullah Medical City, Makkah, Saudi Arabia
  • Naved Yousuf Hasan King Abdullah Medical City, Makkah, Saudi Arabia
  • Noha Ahmed Mohamed Ali King Abdullah Medical City, Makkah, Saudi Arabia
  • Masood Iqbal King Abdullah Medical City, Makkah, Saudi Arabia




hydatid cyst rupture, saline irrigation, hypernatremia, osmotic demyelination, mortality


We are reporting a unique case of ruptured hydatid cyst which required hypertonic saline irrigation which is one of the standard forms of management in these patients. The patient developed iatrogenic acute hypernatremia reaching a level of 197 mmols, which has rarely been described in the literature. The acute rise of serum sodium drastically increases the risk of Osmotic demyelination syndrome. After correction of hypernatremia, the patient improved well, without any neurological deficit. Very few cases have been reported in adults in the literature which survived this degree of hypernatremia without complications, even after successful management, as mortality reaches up to 70 % when serum sodium reaches 160 mmols. Prevention of severe hypernatremia is the cornerstone to decrease mortality. Frequent monitoring of serum sodium level is mandatory to prevent the neurological complications.


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Practicing Physician