title: Rapid correction of severe hyponatremia after hysteroscopic surgery – a case report.
abstract: BACKGROUND
  One of the most feared complications during hysteroscopic surgery is haemodilution by absorption of distension media. One facet of haemodilution, i.e. hyponatremia, can lead to respiratory distress, pulmonary oedema, as well as cardiovascular collapse.
  
  
  METHODS
  Here we report the swift recovery of a 45 year, female, Caucasian patient with acute hyponatremia (74 mEq/L) and pulmonary oedema by the employment of rapid correctional strategies.
  
  
  CONCLUSIONS
  The absorption of irrigation fluids, as presented in this case, is an inevitable side effect of hysteroscopic surgery. Utmost caution should, therefore, be mandatory to reduce and actively monitor fluid intake. If these measures fail, as in the case presented here, it is essential to rapidly eliminate any free water and to normalize the sodium levels. Anecdotal reports of pontine myelinolysis are not in line with literature concerning acute hyponatremia and should, therefore, not obstruct determined action against it.
authors.affiliation: Clinic for gynecology and obstetrics, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, North Rhine-Westphalia, Germany. philip.hepp@med.uni-duesseldorf.de.
authors.forename: Philip
authors.initials: P
authors.lastname: Hepp
authors.affiliation: Clinic for anesthesiology, Klinikum Wolfenbüttel, Wolfenbüttel, Lower Saxony, Germany. tobias.juettner@klinikum-wolfenbuettel.de.
authors.forename: Tobias
authors.initials: T
authors.lastname: Jüttner
authors.affiliation: Clinic for gynecology and obstetrics, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, North Rhine-Westphalia, Germany. ines.beyer@med.uni-duesseldorf.de.
authors.forename: Ines
authors.initials: I
authors.lastname: Beyer
authors.affiliation: Clinic for gynecology and obstetrics, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, North Rhine-Westphalia, Germany. tanja.fehm@med.uni-duesseldorf.de.
authors.forename: Tanja
authors.initials: T
authors.lastname: Fehm
authors.affiliation: Clinic for gynecology and obstetrics, University Ulm, Ulm, Baden-Württemberg, Germany. Wolfgang.Janni@uniklinik-ulm.de.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Janni
authors.affiliation: Clinic for anesthesiology, Heinrich-Heine-University, Düsseldorf, North Rhine-Westphalia, Germany. Enrico.Monaca@med.uni-duesseldorf.de.
authors.forename: Enrico
authors.initials: E
authors.lastname: Monaca
mesh_terms: D000208:Acute Disease; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000209:etiology* / Q000628:therapy; D015907:Hysteroscopy / Q000009:adverse effects* / Q000379:methods; D008875:Middle Aged; D011654:Pulmonary Edema / Q000209:etiology* / Q000628:therapy; D012720:Severity of Illness Index; D016896:Treatment Outcome