Rapid correction of severe hyponatremia after hysteroscopic surgery – a case report

One of the most feared complications during hysteroscopic surgery is haemodilution by absorption of distension media. One facet of haemodilution, i.e. hyponatremia, can lead to respiratory distress, pulmonary oedema, as well as cardiovascular collapse. Here we report the swift recovery of a 45 year,...

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Bibliographic Details
Published in:BMC anesthesiology 2015-06, Vol.15 (1), p.85-85, Article 85
Main Authors: Hepp, Philip, Jüttner, Tobias, Beyer, Ines, Fehm, Tanja, Janni, Wolfgang, Monaca, Enrico
Format: Article
Language:English
Subjects:
Acute Disease
Care and treatment
Case Report
Case studies
Diagnosis
Female
Health aspects
Humans
Hyponatremia
Hyponatremia - etiology
Hyponatremia - therapy
Hysteroscopy
Hysteroscopy - adverse effects
Hysteroscopy - methods
Middle Aged
Pulmonary Edema - etiology
Pulmonary Edema - therapy
Risk factors
Severity of Illness Index
Treatment Outcome
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Summary:One of the most feared complications during hysteroscopic surgery is haemodilution by absorption of distension media. One facet of haemodilution, i.e. hyponatremia, can lead to respiratory distress, pulmonary oedema, as well as cardiovascular collapse. Here we report the swift recovery of a 45 year, female, Caucasian patient with acute hyponatremia (74 mEq/L) and pulmonary oedema by the employment of rapid correctional strategies. The absorption of irrigation fluids, as presented in this case, is an inevitable side effect of hysteroscopic surgery. Utmost caution should, therefore, be mandatory to reduce and actively monitor fluid intake. If these measures fail, as in the case presented here, it is essential to rapidly eliminate any free water and to normalize the sodium levels. Anecdotal reports of pontine myelinolysis are not in line with literature concerning acute hyponatremia and should, therefore, not obstruct determined action against it.
ISSN:1471-2253
1471-2253
DOI:10.1186/s12871-015-0070-4