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

## TL;DR

A man with central diabetes insipidus developed severe complications after surgery due to fluid restriction, highlighting the need for careful perioperative care.

## Contribution

This case report highlights the risks of standard perioperative care in CDI patients and emphasizes the need for individualized fluid and hormone management.

## Key findings

- A CDI patient developed severe hypernatremia and neurological symptoms after postoperative water restriction.
- Prompt fluid resuscitation and desmopressin replacement led to rapid recovery.
- Individualized perioperative management is crucial for CDI patients to prevent complications.

## 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.