[The gynecological TURP syndrome. Severe hyponatremia and pulmonary edema during hysteroscopy].
Fluid overload and dilutional hyponatremia are rare but typical complications of endoscopic transurethral resection of the prostate gland (TURP syndrome). Less commonly, this complication caused by excessive absorption of hypotonic, electrolyte-free non-conductive distention solution, may also occur during endoscopic surgery of the uterus, e.g. operative hysteroscopy. A case report is presented of a 44-year-old woman scheduled for operative hysteroscopy for intracavital myoma under general anaesthesia, suffering from severe absorption syndrome leading to hyponatremia of 106 mEq/l and pulmonary edema necessitating subsequent admission to ICU. Anatomical and physiological as well as technical aspects of this syndrome are discussed. Recommendations for anesthesiology management are offered and a possible treatment of acute hyponatremia is discussed.
Klinik für Anästhesiologie und operative Intensivmedizin, Universitätsklinikum Schleswig-Holstein UKSH, Campus Kiel, Schwanenweg 21, 24105 Kiel, Deutschland. serocki@anaesthesie.uni-kiel.de
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G
Serocki
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Hanss
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Bauer
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J
Scholz
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B
Bein
D000328:Adult; D000768:Anesthesia, General; D001784:Blood Gas Analysis; D003422:Critical Care; D004724:Endoscopy / Q000009:adverse effects*; D005260:Female; D005833:Genital Neoplasms, Female / Q000150:complications / Q000175:diagnosis; D006801:Humans; D007010:Hyponatremia / Q000209:etiology*; D007038:Hypotonic Solutions / Q000009:adverse effects; D015907:Hysteroscopy / Q000009:adverse effects*; D008297:Male; D009214:Myoma / Q000150:complications / Q000175:diagnosis; D011654:Pulmonary Edema / Q000209:etiology*; D020728:Transurethral Resection of Prostate / Q000009:adverse effects*
D007038:Hypotonic Solutions
Das gynäkologische "TUR-Syndrom". Schwere Hyponatriämie und Lungenödem während operativer Hysteroskopie.