Parotid area sign: A clinical test for the diagnosis of fluid overload in hysteroscopic surgery

Sinha, Manju; Hegde, Aparna; Sinha, Rakesh; Goel, Sunita

doi:10.1016/j.jmig.2006.09.017

Cited by 9 publications

(6 citation statements)

References 24 publications

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“…During GA, it is advisable to adhere to a pre-determined schedule for sampling patient blood for serum sodium concentration. The parotid area sign[10] (intraoperative increase in philtrum-mastoid prominence distance) and the ethanol breath test[11] employing 1.5% glycine with added 1% ethanol for irrigation have been proposed as early signs of fluid overload during resectoscopic surgery. Bipolar resectoscopes employing normal saline as distending medium and vaporization techniques are being explored as safer alternatives for the future.…”

Section: Discussionmentioning

confidence: 99%

Operative hysteroscopy intravascular absorption syndrome: A bolt from the blue

2012

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Operative hysteroscopy has emerged as an effective alternative to hysterectomy and has become standard surgical treatment for varied gynaecological conditions like abnormal uterine bleeding and uterine myomas. This procedure requires distention of the uterine cavity for adequate visualization of the operative field. 1.5% glycine is a widely used distention medium because it has good optical properties and is non-conductive. However, the intraoperative absorption of this electrolyte-free fluid can cause hyponatraemia, hypoosmolality, hyperglycinaemia and volume overload, including pulmonary oedema. We report a case of operative hysteroscopy intravascular absorption (OHIA) syndrome, presenting abruptly during hysteroscopic myomectomy, employing 1.5% glycine as the fluid distention medium. Successful management of the case and prevention strategies are discussed.

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Section: Discussionmentioning

confidence: 99%

Operative hysteroscopy intravascular absorption syndrome: A bolt from the blue

2012

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“…However, transcervical resection of fibroids with deep intramural extension is performed only in selected patients [7]. A major concern is that complete hysteroscopic resection might result in uterine perforation or fluid overload [4]. As hysteroscopic myomectomy is at times a highly complex procedure, its real feasibility must be evaluated correctly preoperatively in order to minimize the morbidity and mortality that can occur during the procedure.…”

Section: Discussionmentioning

confidence: 99%

“…Uterine bleeding, perforation and fluid overload are major complications which can occur during hysteroscopic myomectomy if not performed by an experienced surgeon. Prolonged surgery can cause fluid overload leading to electrolyte imbalances and its subsequent complications [4]. This can occur especially during hysteroscopic resection of large submucous myomas.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic removal of large submucous myomas

et al. 2011

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The aim of this study was to analyze the feasibility and technique of removing large submucous myomas laparoscopically. This technique decreases the complications of removing the submucous myoma hysteroscopically. The design was based on a retrospective review (Canadian Task Force Classification II-1) in a dedicated high volume gynecological laparoscopy centre. The subjects were twenty-two women who underwent laparoscopic removal of submucous myomas at our center. Laparoscopic removal of submucous myoma was done in all patients in whom the size of the myoma was more than 5 cm. The results revealed the following: (1) median clinical size of the uterus was 12 weeks (6, 18); (2) median size of the myoma was 7 cm (5, 10); (3) median weight of the specimen was 200 g (60, 460); (4) median total duration of surgery was 75 min (40, 120); (5) median total blood loss was 50 ml (10, 500); and the total morcellation time was 15 min (5, 45). Laparoscopic myomectomy for large submucous myomas is a technically feasible procedure. It can be performed by experienced surgeons irrespective of the size or depth of the myoma. It prevents the complications of hysteroscopic removal of the myoma.

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“…Uterine bleeding, perforation, and fluid overload are major complications that can occur during hysteroscopic myomectomy. 3 Here is a case report of submucous myoma removed laparoscopically.…”

Section: Introductionmentioning

confidence: 99%