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Purpose Sever hyponatremia is associated with a high mortality rate. It can occur during procedures requiring irrigation with a glycine solution. Clinical features A 31-year old female patient underwent transcervical resection of a uterine myoma under general anesthesia. 35 minutes into surgery, a 41 min -1 bradycardia with hypertension (150/86 mmHg) was observed, followed by a 50 cmH 2 O increase in airway pressure and an expired CO 2 of 49 mmHg, a sodium of 100 mmoles L -1 and a negative irrigation fluid water balance of 3000 mL. After administering 600 mL of 3% hypertonic saline, 60 mg of furosemide, performing a transvaginal puncture to release the extravased fluid in the peritoneal cavity, and artificial ventilation for 6 h, positive outcome was finally achieved. Conclusions The resorption syndrome during transcervical resection of a uterine myoma is linked to the passage into the blood of the irrigation fluid that contains glycine. The symptoms are hidden during general anesthesia and severe hyponatremia can occur before the syndrome is detected. RésuméObjectif L'hyponatre´mie se´ve`re est associe´e à un taux de mortalite´e´leve´. Elle peut survenir lors d'interventions impliquant une irrigation avec une solution de glycine. É léments cliniques Il s'agit d'une patiente de 31 ans subissant une re´section d'un myome ute´rin par re´section endoscopique sous anesthe´sie ge´ne´rale. Apre`s 35 min de chirurgie, on note une bradycardie a`41 min -1 avec hypertension arte´rielle a`150/86 mmHg suivie d'un bronchospasme accompagnant un oede`me pulmonaire avec de´saturation a`90 %, augmentation de la pression des voies ae´riennes a`50 cmH 2 O, une pression partielle de CO 2 expire´a`49 mmHg, une natre´mie a`100 mmol Á L -1 et un bilan hydrique du liquide d'irrigation ne´gatif de 3000 mL. L'administration de 600 mL de se´rum sale´hypertonique a3 %, l'injection de furose´mide 60 mg, une ponction transvaginale e´vacuatrice du liquide extravase´en intrape´ritone´al, ainsi qu'une ventilation artificielle durant 6 h conduisent a`une e´volution favorable. Conclusion Le syndrome de re´sorption au de´cours de la re´section endoscopique d'un myome ute´rin est lie´au passage dans le sang du liquide d'irrigation contenant de la glycine. Les symptômes sont masque´s au cours de l'anesthe´sie ge´ne´rale et une hyponatre´mie se´ve`re peut survenir avant que le syndrome soit de´tecte´.

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Purpose: Gastric plication of the greater curvature is spreading over all the bariatric centers as a new investigational procedure for the treatment of morbid obesity. Conventional bariatric surgeries 'gastric band','sleeve gastrectomy','vertical banding gastroplasty' and 'gastric bypass' are associated with severe complications and a high rate of failure or weight regain. Materials and methods:Authors present their experience on 482 laparoscopic greater curvature plication (LGCP) performed over a period of 26 months. A total of 449 patients responded to inclusion criteria:147 men and 302 women. Their mean age was 35.99 ± 10.85 years. Their mean body mass index (BMI) was equal to 39.93 ± 6.15 kg/m 2 . Results:The average percentage of excess weight loss (%EWL) at 1, 3, 6, 12, 18 and 24 months was 30.19, 47.07, 63.05, 68.15, 68.62 and 69.29% respectively. Moreover, this study was divided into two subgroups and results were studied based on the type of suturing and patient's BMI over a period of 1 year. The first subgroup included 183 patients, where gastric plication was performed with continuous suturing at the first and second row. The second subgroup included 186 patients, where gastric plication was performed with separated stitches at the first row and continuous suturing at the second row. In the second subgroup, a higher degree of %EWL was found. The complication rate was greater in the first subgroup.The overall rate of immediate surgical complications was 1.33%. Mean hospital stay was 36 hours. Conclusion:Gastric plication is safe and efficient on EWL based on short-term results. Separated suturing is associated with a higher %EWL and a lower rate of complications, with a short hospital stay. Long-term data are needed to consolidate these results.