Korean J Anesthesiol.  2011 Jun;60(6):440-443. 10.4097/kjae.2011.60.6.440.

Extreme hyponatremia with moderate metabolic acidosis during hysteroscopic myomectomy: A case report

• Jo YY
• Jeon HJ
• Choi E
• Choi YS

• KMID: 1766660
• DOI: http://doi.org/10.4097/kjae.2011.60.6.440

Abstract

Excess absorption of fluid distention media remains an unpredictable complication of operative hysteroscopy and may lead to lethal conditions. We report an extreme hyponatremia, caused by using an electrolyte-free 5 : 1 sorbitol/mannitol solution as distention/irrigation fluid for hysteroscopic myomectomy. A 34-year-old female developed severe pulmonary edema and extreme hyponatremia (83 mmol/L) during transcervical endoscopic myomectomy. A brain computed tomography showed mild brain swelling without pontine myelinolysis. The patient almost fully recovered in two days. Meticulous attention should be paid to intraoperative massive absorption of fluid distention media, even during a simple hysteroscopic procedure.

Keyword

Hyponatremia; Hysteroscopy

MeSH Terms

Absorption
Acidosis
Adult
Brain
Brain Edema
Female
Humans
Hyponatremia
Hysteroscopy
Pulmonary Edema