Severe hypocalcemia caused by absorption of sorbitol-mannitol solution during hysteroscopy.
Hysteroscopic procedure can be complicated by intravascular absorption of irrigating fluid. The clinical features of this complication are similar to transurethral resection of the prostate (TURP) syndrome. There have been few reports on hypocalcemia during endoscopic surgery and clinical implications of hypocalcemia in TURP syndrome have been underestimated. We report a case of TURP syndrome association with a decreased ionized calcium concentration of 0.53 mM/L after the absorption of a large amount of sorbitol-mannitol solution during hysteroscopy. The hypotension which occurred in TURP syndrome did not respond to vasopressor and inotropic agent but responded to the administration of calcium. This case was also accompanied by hyponatremia, hyperglycemia and lactic acidosis through the metabolism of sorbitol.
Lee
Guie Yong
GY
Department of Anesthesiology and Pain Medicine, Ewha Womans University, School of Medicine, Seoul, Korea. lgyanes@ewha.ac.kr
Han
Jong In
JI
Heo
Hyun Joo
HJ
D005260:Female; D006801:Humans; D006996:Hypocalcemia / Q000139:chemically induced* / Q000175:diagnosis* / Q000628:therapy; D015907:Hysteroscopy; D007430:Intraoperative Care; D008353:Mannitol / Q000009:adverse effects*; D008875:Middle Aged; D011654:Pulmonary Edema / Q000000981:diagnostic imaging; D011859:Radiography; D013012:Sorbitol / Q000009:adverse effects*; D007507:Therapeutic Irrigation
D008353:Mannitol; D013012:Sorbitol