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Life-threatening laryngeal edema and hyponatremia during hysteroscopy


Wegmüller, Barbara; Hug, Kerstin; Meier Buenzli, Charlotte; Yuen, Bernd; Maggiorini, Marco; Rudiger, Alain (2011). Life-threatening laryngeal edema and hyponatremia during hysteroscopy. Critical Care Research and Practice, 2011:140381.

Abstract

We report on a 43-year-old patient undergoing a hysteroscopic myomectomy. After 80 minutes of operation, the patient developed laryngeal edema, requiring emergency tracheostomy. Hyponatremia (serum sodium 78 mmoL/L) indicated an irrigation fluid absorption. The patient developed shock, acute respiratory distress syndrome, acute renal failure, and diffuse intravascular coagulopathy. Resuscitation including continuous venovenous hemodiafiltration was required. Finally, the patient made a full clinical recovery. Hysteroscopy usually has low risks. However, absorption of the irrigation fluid can result in life-threatening fluid overload and electrolyte disturbances. Accurate fluid balancing and limiting the operation time may prevent these complications.

Abstract

We report on a 43-year-old patient undergoing a hysteroscopic myomectomy. After 80 minutes of operation, the patient developed laryngeal edema, requiring emergency tracheostomy. Hyponatremia (serum sodium 78 mmoL/L) indicated an irrigation fluid absorption. The patient developed shock, acute respiratory distress syndrome, acute renal failure, and diffuse intravascular coagulopathy. Resuscitation including continuous venovenous hemodiafiltration was required. Finally, the patient made a full clinical recovery. Hysteroscopy usually has low risks. However, absorption of the irrigation fluid can result in life-threatening fluid overload and electrolyte disturbances. Accurate fluid balancing and limiting the operation time may prevent these complications.

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Additional indexing

Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Institute of Anesthesiology
Dewey Decimal Classification:610 Medicine & health
Uncontrolled Keywords:case report
Language:English
Date:2011
Deposited On:09 Jan 2012 21:52
Last Modified:13 Sep 2017 16:37
Publisher:Hindawi Publishing Corporation
ISSN:2090-1305
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:https://doi.org/10.1155/2011/140381
PubMed ID:21541246

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