Pulmonary edema and hyponatremia after hysteroscopic uterine septectomy : A case report

Kim, Won Sung; Yoon, Ji Young; Jeong, Kyu Yeon; Kwon, O Sun

Case Report

General Article

Anesthesia and Pain Medicine 2009;4(1):75-78.
Published online January 30, 2009.

Pulmonary edema and hyponatremia after hysteroscopic uterine septectomy : A case report

Won Sung Kim, Ji Young Yoon, Kyu Yeon Jeong, O Sun Kwon

Department of Anesthesiology and Pain Medicine, Pusan National University College of Medicine, Busan, Korea. dryoonji@hanmail.net

Abstract

The hysteroscope has become a standard part of gynecologists' armamentarium, and hysteroscopy is taught routinely in residency curriculums. In recent years, its use in gynecology has changed from a diagnostic tool only to an instrument for gynecologic operations. An electrolyte-free irrigation fluid is used for hysteroscopic surgery, and it has a possibility of substantial absorption of irrigation fluid. The absorption depends on the rate, volume and nature of the irrigation fluid. Fortunately, large-scale fluid absorption is rare but leads to symptoms severe enough to require intensive care. Several methods have been proposed to reduce the risk but none of them is capable of preventing the complication from fluid absorption. In this case, the patient had pulmonary interstitial edema with hyponatremia after hysteroscopic uterine septectomy but that had resolved without sequelae.

Key Words: dilutional hyponatremia, hysteroscopy, irrigation fluid, pulmonary edema