Hyponatremic seizures after suprapubic catheter placement in 7-year-old child.
We report a case of hyponatremic seizures in a 7-year old boy with spina bifida following cystoscopy and suprapubic catheter placement. Immediate postoperative cystogram and pelvic computed tomogram (CT) after the development of seizures demonstrated a fluid collection from the suprapubic catheter site into the anterior abdominal wall. The subsequent reabsorption of free water from the fluid collection, with the contribution of postoperative hypotonic intravenous fluid administration and possible transient inappropriate antidiuretic hormone (ADH) secretion resulted in acute dilutional hyponatremia and consequent seizures. Strategies to prevent hyponatremia in children during urological procedures, with emphasis on the importance of reserving free water as the irrigation fluid are discussed.
Szolnoki
J M
JM
Department of Anesthesiology, State University of New York, Upstate Medical University, Syracuse, New York 13210, USA.
Puskas
F
F
Sweeney
D M
DM
Camporesi
E M
EM
Upadhyay
J
J
D034861:Abdominal Wall; D000927:Anticonvulsants / Q000008:administration & dosage; D002404:Catheterization / Q000009:adverse effects*; D002648:Child; D003558:Cystoscopy / Q000379:methods*; D004232:Diuretics / Q000008:administration & dosage; D005665:Furosemide / Q000008:administration & dosage; D005947:Glucose / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007010:Hyponatremia / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D007177:Inappropriate ADH Syndrome / Q000209:etiology; D008140:Lorazepam / Q000008:administration & dosage; D008297:Male; D010388:Pelvis / Q000000981:diagnostic imaging; D011183:Postoperative Complications / Q000097:blood / Q000209:etiology*; D012640:Seizures / Q000188:drug therapy / Q000209:etiology*; D012965:Sodium Chloride / Q000008:administration & dosage; D016135:Spinal Dysraphism / Q000150:complications; D007507:Therapeutic Irrigation / Q000009:adverse effects; D014057:Tomography, X-Ray Computed / Q000379:methods; D014882:Water-Electrolyte Balance
D000927:Anticonvulsants; D004232:Diuretics; D012965:Sodium Chloride; D005665:Furosemide; D005947:Glucose; D008140:Lorazepam