Table of Contents Author Guidelines Submit a Manuscript
Critical Care Research and Practice
Volume 2011 (2011), Article ID 140381, 4 pages
http://dx.doi.org/10.1155/2011/140381
Case Report

Life-Threatening Laryngeal Edema and Hyponatremia during Hysteroscopy

1Medical Intensive Care Unit, University Hospital Zurich, Raemistraße 100, 8091 Zurich, Switzerland
2Department of Anesthesiology, Balgrist University Hospital, 8008 Zurich, Switzerland
3Gynecology and Obstetrics, Canton Hospital Nidwalden, 6370 Stans, Switzerland
4Anesthesiology and Intensive Care, Canton Hospital Nidwalden, 6370 Stans, Switzerland
5Intensive Care Unit, Hospital Bülach, 8180 Bülach, Switzerland

Received 18 November 2010; Accepted 27 January 2011

Academic Editor: Andrew F. Shorr

Copyright © 2011 Barbara Wegmüller et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.