Ureteral injury presenting with hyponatremia.
BACKGROUND
Ureteral injuries in gynecologic surgery, although rare, classically present with a well-described constitution of symptoms. Hyponatremia in association with ureteral injury has not been described.


METHODS
A 44-year-old multiparous woman presented with chronic pelvic pain and a persistent adnexal mass underwent exploratory laparotomy, lysis of adhesions, and left salpingo-oophorectomy. On postoperative day 5, she demonstrated classic signs and symptoms of ureteral obstruction. In addition, she developed hyponatremia with a serum sodium concentration of 124 mEq/L that immediately resolved after percutaneous drainage of the urinoma.


CONCLUSIONS
Hyponatremia may develop with untreated and unrecognized ureteral injuries. Serum electrolytes may be helpful in the evaluation of suspected ureteral injury.
Lukacz
E S
ES
Department of Reproductive Medicine, University of California, San Diego Medical Center, San Diego, California 92103, USA. mimilukacz@aol.com
Nager
C W
CW
D000328:Adult; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007010:Hyponatremia / Q000209:etiology*; D007431:Intraoperative Complications; D010298:Parity; D011183:Postoperative Complications / Q000209:etiology*; D014513:Ureter / Q000293:injuries*