Hyponatremia is an electrolyte disorder frequently encountered in clinical practice. The first step in the diagnostic evaluation of hyponatremia is the volume assessment (clinical estimation of hypo/hypervolemia presence). In the cases of euvolemic hyponatremia, followed by decreased plasma osmolality (<275mOsm/kg) with urine osmolality >100mOsm/kg, urine sodium >30mmol/L along with normal intake of salt and water, preserved pituitary, adrenal, thyroid, adrenal function as well as no recent use of diuretics, syndrome of inappropriate diuresis (SIAD) is diagnosed. In symptomatic, especially acute hyponatremia, careful and gradual substitution by 3 (10) % sodium-chloride infusion is advised with liquid intake restriction, the administration of demeclocycline, urea, or vaptans, as well as causal treatment of SIAD. SIAD is often transient and etiologically clear. In this paper, we present two cases with idiopathic, chronic SIAD with poor outcomes. During the diagnostic follow-up, the cause of SIAD was not found. The autopsy finding was also adverse. In most cases, euvolemic hyponatremia in patients with chronic, idiopathic SIAD is an ominous sign.

Zemun hospital, the present-day Clinical Hospital Zemun-Belgrade, was founded in 1784, is the oldest hospital in the Serbia. For over two centuries, it blazed the trial and still pioneers in the application of numerous advanced medical achievements and knowledge in this region.

The development of Zemun Hospital in the 19th century was followed by better work conditions and an increasing number of patients. The arrival of doctor Vojislav Subotić to the hospital and his work were key moments in the general improvement of the hospital. Since 1887, the hospital was administered by a society known as „Sisters of Charity of Saint Vincent De Paul“. By the end of 1891, they had constructed a new hospital building.

The 20th century was the most eventful period in the history of Zemun Hospital and it brought many changes. Working through out both world wars, the hospital staff aided those who were wounded or ill, both soldiers and civilians. Throughout this period, the hospital worked in three different countries, under various administrations and owners.

Colorectal cancer, as one of the leading oncological causes of disease worldwide, is a major challenge in terms of treatment and patient access. Technological advances have made it possible to apply a minimally invasive laparoscopic surgical technique that has proven superior to open surgery. In order to optimize treatment, reduce mortality and morbidity, a perioperative strategy has been developed summarized in the principles of ERAS protocol (Enhanced Recovery After Surgery). The basic postulates of the ERAS protocol include prehabilitation, comorbidity control, prevention of postoperative nausea and vomiting, minimally invasive surgical method, multimodal analgesia, achieving euvolemia, prevention of hypothermia and early mobilization of the patient. The principles of the ERAS protocol are based on evidence to support safety, applicability and effectiveness, however, there are not yet enough studies to examine the long-term benefits of their implementation. The implementation of the ERAS protocol at KBC “Dr Dragisa Misovic -Dedinje” is not complete, but there is significant compliance with the guidelines of the 2018 ERAS Association, which has reduced inpatient stays and the number of postoperative complications. Although there is ample evidence to support the safety and effectiveness of this treatment approach, a multimodal strategy poses a major challenge to traditional surgical doctrine, making its implementation slow and incomplete in practice.