Roy W J, Thomas B L, Horowitz I R
Department of Obstetrics and Gynecology, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
Gynecol Oncol. 1997 May;65(2):360-2. doi: 10.1006/gyno.1997.4657.
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.
腹膜假黏液瘤是一种由肿瘤性上皮产生大量黏多糖为特征的病症。尽管可尝试手术减瘤并清除黏液性腹水，但往往无法完全清除这些物质。有人主张用10%葡萄糖水溶液（D10W）进行腹腔灌洗，以防止黏液再次积聚以及预防诸如肠梗阻等需要再次剖腹手术的并发症。我们描述了一名因巨大腹盆腔肿物接受手术的患者。剖腹手术时，发现卵巢黏液性囊腺癌伴有大量黏稠的黏液性腹水和腹膜种植转移灶。为了更有效地清除黏液并防止其随后再次积聚，用10%葡萄糖水溶液（D10W）进行了腹腔灌洗。该患者既往无葡萄糖不耐受病史，但随后很快被发现血糖严重升高（血清葡萄糖>500mg/dl）。她接受了胰岛素治疗并康复，未留下明显后遗症。从业者应意识到这种与腹腔内滴注葡萄糖相关的潜在危险并发症。
