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September 10, 2025Open Access

Perianal Abscess in a Patient With Central Diabetes Insipidus: A Case Report

YDYuxin DuShanghai University of Traditional Chinese Medicine ZHZongqi HeShanghai University of Traditional Chinese Medicine

Key Points

Upon surgery for a perianal abscess, the CDI patient developed severe hypernatremia, indicating critical fluid management needs.
The case demonstrates the impact of individualized perioperative care for patients with endocrine disorders like central diabetes insipidus.
Endocrinology consultation and prompt fluid resuscitation led to the patient's swift recovery after surgery.
Proper use of desmopressin and tailored fluid strategies are essential in managing CDI patients during surgical procedures.

Abstract

Central diabetes insipidus (CDI) is a rare endocrine disorder that can pose significant risks in the perioperative setting, especially when routine fasting and fluid restriction are applied. We report the case of a 34-year-old man with a history of CDI who underwent surgical drainage of a perianal abscess and subsequently developed severe hypernatremia and neurological symptoms due to postoperative water restriction. Prompt fluid resuscitation and endocrinology consultation led to rapid recovery. This case underscores the importance of early recognition and individualized perioperative management, including desmopressin replacement and tailored fluid strategies in CDI patients undergoing surgery.

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