A Case of Hyperosmolar Nonketotic Coma (HONKC) after Surgery for Laryngeal Carcinoma

Abstract

We report a case of hyperosmolar nonketotic coma that developed postoperatively in a patient with cancer of the larynx.
The patient was a 69-year-old man, who underwent frontolateral laryngectomy.
He suddenly became comatose on the 17th day after surgery and examination revealed HONKC. A low rate of continuous intravenous drip infusion of insulin and fluid replacement were initiated.
Despite subsequent acute renal failure, sepsis, disseminated intravascular coaglation and rhabdomyolysis, the patient is still alive to date. HONKC is rare as a postoperative complication, but can be fatal.
Careful postoperative care is needed for patients with diabetes mellitus.