title: Post operative delirium with hyponatriemia after transurethral resection of the prostate: a case of transurethral resection syndrome?
abstract: Postoperative delirium is one of the most spectacular, frightening and misdiagnosed postoperative complications of surgery. We describe the case of a caucasian 77-year-old male patient, who developed a severe postoperative delirium after combined transurethral resection of the prostate and cystolithotripsy. This systemic and unpredictable complication of endoscopic surgery is caused by excessive absorption of electrolyte-free irrigation fluids, leading to brain edema and metabolic encephalopathy. The clinical spectrum ranges from asymptomatic hyponatraemia, to electrocardiographic (ECG) changes, nausea, vomiting, convulsions, coma, pulmonary edema, cardiovascular compromise and death. Because of the heterogeneous clinical presentation diagnosis can be difficult. In a patient who develops alterations of consciousness with evidence of hypervolemia and hyponatremia after endoscopic surgery, transurethral resection syndrome must be considered.
authors: Neurological Department, Ospedale Cardinal Massaia, Asti, Italy. mcavallini@asl.at.it
authors: Maurizio
authors: M
authors: Cavallini
authors: Maria Gabriella
authors: MG
authors: Saracco
authors: Marco
authors: M
authors: Aguggia
mesh_terms: D000368:Aged; D003693:Delirium / Q000209:etiology*; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000503:physiopathology*; D011470:Prostatic Hyperplasia / Q000601:surgery; D020728:Transurethral Resection of Prostate / Q000009:adverse effects*