title: Life-Threatening Laryngeal Edema and Hyponatremia during Hysteroscopy.
abstract: We report on a 43-year-old patient undergoing a hysteroscopic myomectomy. After 80 minutes of operation, the patient developed laryngeal edema, requiring emergency tracheostomy. Hyponatremia (serum sodium 78 mmoL/L) indicated an irrigation fluid absorption. The patient developed shock, acute respiratory distress syndrome, acute renal failure, and diffuse intravascular coagulopathy. Resuscitation including continuous venovenous hemodiafiltration was required. Finally, the patient made a full clinical recovery. Hysteroscopy usually has low risks. However, absorption of the irrigation fluid can result in life-threatening fluid overload and electrolyte disturbances. Accurate fluid balancing and limiting the operation time may prevent these complications.
authors.affiliation: Medical Intensive Care Unit, University Hospital Zurich, Raemistraße 100, 8091 Zurich, Switzerland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Wegmüller
authors.forename: Kerstin
authors.initials: K
authors.lastname: Hug
authors.forename: Charlotte
authors.initials: C
authors.lastname: Meier Buenzli
authors.forename: Bernd
authors.initials: B
authors.lastname: Yuen
authors.forename: Marco
authors.initials: M
authors.lastname: Maggiorini
authors.forename: Alain
authors.initials: A
authors.lastname: Rudiger