Cerebral Edema Associated with Hyponatremia After Hysteroscopic Myomectomy

The hypotonic fluid used for distention of the uterus during hysteroscopic myomectomy creates hyponatremia and hypervolemia with resulting cerebral edema. This situation is called operative hysteroscopy ıntravascular absorption syndrome. A 33-year-old woman was admitted for elective hysteroscopic myomectomy with general anesthesia. Sorbitol/mannitol solution was used as a distending solution for surgical hysteroscopy. The patient did not wake up after the operation and generalized seizures had been started. Hyponatremia was detected in her blood tests and started to be corrected rapidly with hypertonic saline. Brain edema was considered in her cranial magnetic resonance imaging. The patient was completely recovered after the treatment. This case is the case of brain edema caused by hyponatremia occurring after hysteroscopic surgery. It was presented with rarely reported symptoms such as seizures and psychosis, which resulted in a good prognosis. A case of acute cerebral edema progressing in this way has been rarely reported in the literature.

Keywords: Cerebral edema; Hyponatremia; Hysteroscopic myomectomy