A clinical case of hypotonic hyperhydration and cerebral edema after gastric lavage in a young child

Gastric lavage is widely used in Ukraine to accelerate the removal of poisons from the gastrointestinal tract. However, its clinical efficacy has not been confirmed in multiple controlled studies, and life-threatening complications of this procedure include aspiration pneumonia, esophageal or gastric perforation, laryngospasm, hypoxia, arrhythmias, and fluid and/or electrolyte imbalance. The aim is to describe the features of diagnosis and treatment of cerebral edema with hypotonic hyperhydration in a 4 child after excessive administration of drinking water during gastric lavage. Clinical case. A report of a clinical case of successful treatment of cerebral edema with hypotonic hyperhydration in a 4-year-old child after excessive administration of drinking water during gastric lavage due to accidental inadvertent intake of levothyroxine is presented. Conclusions. Hyponatremia as a cause of hypoosmolar hyperhydration is a rare and life-threatening condition that can complicate gastric lavage in young children. The possibility of hyponatremia should also be carefully evaluated in all pediatric patients with intoxications with substances that can potentially increase antidiuretic hormone secretion, and isotonic saline should be used as a gastric lavage solution as well as for infusion therapy. For the most favorable prognosis, it is important to quickly increase the serum concentration of sodium by 5 mmol/l by intravenous infusion of hypertonic 3% sodium chloride solution, in its absence - 20% mannitol solution. This study did not involve any experiments on animals or humans. Written informed consent for treatment and publication of this case was obtained from the child's mother. No conflict of interests was declared by the authors.