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

Gynecol Oncol. 1997 May;65(2):360-2. doi: 10.1006/gyno.1997.4657.

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.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Aged
  • Cystadenocarcinoma / surgery
  • Female
  • Glucose / adverse effects*
  • Humans
  • Hyperglycemia / chemically induced*
  • Intraoperative Complications / chemically induced*
  • Laparotomy
  • Neoplasms, Multiple Primary*
  • Ovarian Neoplasms / surgery
  • Peritoneal Lavage*
  • Peritoneal Neoplasms / therapy*
  • Pseudomyxoma Peritonei / therapy*

Substances

  • Glucose