Dilutional Hyponatremia During Endoscopic Curettage

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Abstract
In 1910, Jacobaeus described the application of endoscopy to inspect the peritoneum, pleura, and pericardium (1). Since that time, gynecologists have developed the instrumentation, operative principles, and techniques of laparoscopic surgery. Recently, reports of laparoscopic techniques have been described not only for cholecystectomy and gynecologic surgery, but also for appendectomy (21, inguinal hernia repair (31, nephrectomy (4), splenectomy (5), and hemicolectomy (6). In 1967, Steptoe (7) published the technique of laparoscopic surgery in gynecologic practice. The technique (using a urologic resectoscope) has been adopted widely by practitioners and has been modified to suit several different surgical procedures. Two of the most frequent surgical complications associated with gynecologic laparoscopic surgery are bleeding and viscus perforation. Although hyponatremia is a well recognized complication of transurethral prostatectomy (TURP), we report the occurrence of this complication in a female patient undergoing endoscopic uterine surgery. Since the frequency of laparoscopic surgery continues to increase, and relatively few cases of dilutional hyponatremia during endoscopic surgery have been published (8–10), we present this case to emphasize the potential for this complication and the paucity of currently available monitoring techniques.

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