2016 Volume 36 Issue 4 Pages 787-789
A 16-year-old male with congenital nephrogenic diabetes insipidus was diagnosed as having perforated appendicitis and panperitonitis and admitted for emergency surgery. His daily fluid intake was 10 liters. The operative diagnosis was gangrenous appendicitis, no perforation. After the operation, the patient was administered electrolytes every two hours. Maintenance fluid transfusion was undertaken at the rate of 80mL/hr. In addition, 5% dextrose equivalent for every two-hours' urine output was given for the replacement of free water loss. Postoperatively, no remarkable changes were observed in the serum electrolyte levels. Severe osmotic dehydration with potential neurologic sequelae can develop in congenital nephrogenic diabetes insipidus patients mainly infused with crystalloid fluids. The urine output and serum electrolyte levels must be closely monitored. Among the more favorable intravenous fluids is 5% dextrose, and oral fluid intake should be resumed as soon as possible.