Symptomatic hyponatremia and hyperglycemia complicating hysteroscopic resection of intrauterine adhesion： a case report  

作　　者：YANG Bao-jun FENG Li-min 

机构地区：[1]Department of Obstetrics and Gynecology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100050,China

出　　处：《Chinese Medical Journal》2012年第8期1508-1510,共3页中华医学杂志（英文版）

摘　　要：Hysteroscopic surgery is a minimally invasive procedure for the treatment of intrauterine pathologies. However, it can result in fatal complications. We herein report a case of symptomatic hyponatremia and hyperglycemia during hysteroscopic resection of severe intrauterine adhesion with 5% dextrose in water as the distension medium. Because of the difficulty of the incision, the infusion pressure was 100 to 150 mmHg, and surgery was continued for 70 minutes. A total of 19 L of 5% dextrose in water was used as an irrigating fluid. Large-scale absorption of irrigating fluid （3 L） induced dilutional hyponatremia （120 mmol/L） and hyperglycemia （30 mmol/L）. Initial signs were abnormal flatulence and postoperative coma. Hypertonic saline, diuretics, insulin, and liquid restriction were the prevailing treatment strategies for hyponatremia and hyperglycemia. Ionized calcium and potassium levels decreased during treatment. We emphasize the importance of prevention, recognition, and a meticulous perioperative treatment standard. Surgical teams must be vigilant in fluid deficit monitoring and serum electrolyte analysis.Hysteroscopic surgery is a minimally invasive procedure for the treatment of intrauterine pathologies. However, it can result in fatal complications. We herein report a case of symptomatic hyponatremia and hyperglycemia during hysteroscopic resection of severe intrauterine adhesion with 5% dextrose in water as the distension medium. Because of the difficulty of the incision, the infusion pressure was 100 to 150 mmHg, and surgery was continued for 70 minutes. A total of 19 L of 5% dextrose in water was used as an irrigating fluid. Large-scale absorption of irrigating fluid （3 L） induced dilutional hyponatremia （120 mmol/L） and hyperglycemia （30 mmol/L）. Initial signs were abnormal flatulence and postoperative coma. Hypertonic saline, diuretics, insulin, and liquid restriction were the prevailing treatment strategies for hyponatremia and hyperglycemia. Ionized calcium and potassium levels decreased during treatment. We emphasize the importance of prevention, recognition, and a meticulous perioperative treatment standard. Surgical teams must be vigilant in fluid deficit monitoring and serum electrolyte analysis.

关 键 词：distension media HYSTEROSCOPY HYPONATREMIA HYPERGLYCEMIA 

分 类 号：S858[农业科学—临床兽医学] TS218[农业科学—兽医学]