Armour A
State Pathologists Department, Institute of Forensic Medicine, Belfast, United Kingdom.
J Clin Pathol. 1997 May;50(5):444-6. doi: 10.1136/jcp.50.5.444.
A four year old boy with polyuric renal failure resulting from recurrent urinary tract infections and vesicoureteric reflux from birth underwent renal transplantation. In the past he had had five ureteric reimplant operations and a gastrostomy, as he ate nothing by mouth. He required peritoneal dialysis 13 hours a night, six nights a week. His fluid requirements were 2100 ml per day. This included a night feed of 1.5 litres Nutrizon. Before operation he received 900 ml of Dioralyte instead of the Nutrizon feed, and peritoneal dialysis was performed as usual. The operation itself was technically difficult and there was more blood loss than anticipated, requiring intravenous fluids and blood. The operation ended about four hours later but he did not wake up. Urgent computed tomography revealed gross cerebral oedema. He died the next day. At necropsy the brain was massively oedematous and weighed 1680 g.
一名4岁男孩因反复尿路感染和自出生起就存在的膀胱输尿管反流导致多尿性肾衰竭，接受了肾移植手术。过去，由于他无法经口进食，他曾接受过5次输尿管再植手术和一次胃造口术。他每晚需要进行13小时的腹膜透析，每周6晚。他每天的液体需求量为2100毫升。这包括一次1.5升能全力的夜间喂养。手术前，他接受了900毫升口服补液盐而非能全力喂养，并像往常一样进行了腹膜透析。手术本身技术难度较大，失血比预期更多，需要静脉输液和输血。手术约4小时后结束，但他没有醒来。紧急计算机断层扫描显示严重脑水肿。他于次日死亡。尸检时，大脑出现大量水肿，重量为1680克。
