{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:50:56Z","timestamp":1791910256136,"version":"4.3.4"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T00:00:00Z","timestamp":1601510400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T00:00:00Z","timestamp":1601510400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["JA Clin Rep"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Hyponatremia can be developed during hysteroscopic surgery with electrolyte-free irrigation fluid. We experienced severe hyponatremia with postoperative seizures and confirmed mild brain edema.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Case presentation<\/jats:title>\n<jats:p>A quadragenarian female patient underwent a 2-h hysteroscopic myomectomy with electrolyte-free fluid for uterine distension under general anesthesia. Plasma sodium level of 84.1\u2009mmol\/L 100\u2009min after the start of surgery indicated excessive absorption of the irrigation fluid. Acute severe hyponatremia was diagnosed with significant edema in the conjunctiva, lip, and extremities. She was treated with a continuous infusion of hypertonic saline. However, seizures and cerebral edema developed 7\u2009h later. The patient recovered without neurological deficits at postoperative day 2.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The electrolyte-free irrigation fluid can be absorbed rapidly during hysteroscopic surgery. Its interruption with hyponatremia should be considered against prolonged surgery. Especially under general anesthesia, caution should be exercised because the typical symptoms of hyponatremia such as nausea and confusion are blinded.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s40981-020-00381-0","type":"journal-article","created":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T15:04:18Z","timestamp":1601564658000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Severe hyponatremia with seizures and confirmed mild brain edema by hysteroscopic myomectomy: a case report"],"prefix":"10.1186","volume":"6","author":[{"given":"Haruko","family":"Okazaki","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norikazu","family":"Miura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Kashima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryoichi","family":"Miyashita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsunori","family":"Oe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiko","family":"Kawakami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuya","family":"Ishikawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4702-9874","authenticated-orcid":false,"given":"Kenichi","family":"Masui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,10,1]]},"reference":[{"key":"381_CR1","doi-asserted-by":"publisher","first-page":"982","DOI":"10.1016\/j.bpobgyn.2015.03.009","volume":"29","author":"PM McGurgan","year":"2015","unstructured":"McGurgan PM, McIlwaine P. Complications of hysteroscopy and how to avoid them. Best Pract Res Cl Ob. 2015;29:982\u201393.","journal-title":"Best Pract Res Cl Ob."},{"key":"381_CR2","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1093\/humupd\/dmm041","volume":"14","author":"SA Di Spiezio","year":"2007","unstructured":"Di Spiezio SA, Mazzon I, Bramante S, Bettocchi S, Bifulco G, Guida M, et al. Hysteroscopic myomectomy: a comprehensive review of surgical techniques. Hum Reprod Update. 2007;14:101\u201319.","journal-title":"Hum Reprod Update."},{"key":"381_CR3","doi-asserted-by":"publisher","first-page":"881","DOI":"10.1016\/S0015-0282(97)00335-X","volume":"68","author":"MH Emanuel","year":"1997","unstructured":"Emanuel MH, Hart A, Wamsteker K, Lammes F. An analysis of fluid loss during transcervical resection of submucous myomas. 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The other authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"74"}}