SIADH following laparoscopic cholecystectomy

Abstract

Clinical Report SIADH following laparoscopic cholecystectomyPurpose: To present an unusual case of inappropriate antidiuretic hormone secretion syndrome a~er a minor surgical procedure in a healthy patient.Clinical features: A 71-yr-old woman underwent uneventful laparoscopic cholecystectomy for gallstones under general anaesthesia. Fifty-two hours post operatively she began convulsing and was found to have a serum sodium concentration as low as I 12 mmol'L -~. Serum osmolality, urinary sodium concentration and urine osmolality suggested a diagnosis of inappropriate antidiuretic hormone secretion. Subsequent treatment with anticonvulsants followed by strict fluid restriction which increased serum sodium concentrations led to rapid recovery. Conclusion:The syndrome of inappropriate ADH secretion has several well documented causes including major surgery. Few episodes have been described following minor surgery in healthy patients and the only possible risk factor evident in this patient could be her advancing years.Objectif : Rapporter un cas inusit~ de s~cr~tion inappropri~e d'hormone antidiur~tique (SIADH) apr~s une procedure chirurgicale mineure chez une patiente en bonne sant~.

Breast Cancer Presenting with the Syndrome of Inappropriate Secretion of Antidiuretic Hormone after Simple Mastectomy.

“…Miller et al reported findings of a large retrospective study of idiopathic hyponatremia in an ambulatory geriatric population which support the hypothesis that aging is a risk factor for the development of SIADH-like hyponatremia in a subset of older patients without any apparent underlying etiology (1 1). Corn forth reported that an elderly patient, with a preoperative serum sodium concentration at the lower end of the normal range, had presented SIADHafter laparoscopic cholecystectomy (9). They believed it reasonable to recognize that their patient might be within a subset of elderly people at the risk of developing SIADHwithout other risk factors described by Miller et al ( case, the possibility of the restriction having been insufficient cannot be ruled out.…”

Syndrome of inappropriate secretion of antidiuretic hormone after endoscopic submucosal dissection for early gastric cancer

“…Miller et al [27] reported findings of a large study of apparent idiopathic hyponatremia in an ambulatory geriatric population, which supports the hypothesis that aging is a risk factor for the development of SIADH-like hyponatremia in patients with no other apparent underlying etiology. Some authors have reported that elderly patients with a preoperative serum sodium concentration at the lower end of the normal range developed SIADH after relatively minor surgeries [3,8]. They believed it reasonable to recognize that their patients might be within a subset of elderly people at risk for developing SIADH without other risk factors, and that a relatively minor surgical procedure might have increased their patients' susceptibility to the syndrome.…”

“…Recently there have been reports of SIADH in patients undergoing minor surgeries, such as laparoscopic cholecystectomy, appendectomy, and cataract extraction under local anesthesia [2][3][4][5][6][7][8][9][10][11][12]. In terms of endoscopic treatment, no case of SIADH has been reported, although several reports have shown patients with hyponatremia after preparation for colonoscopy [17][18][19].…”

“…The predominant mechanism of the decreased sodium levels is thought to be the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Recently there have been reports of symptomatic hyponatremia and SIADH in patients undergoing minor surgeries such as laparoscopic cholecystectomy and appendectomy [2][3][4][5][6][7][8][9][10][11][12], and several patients suffered permanent brain damage or death [6,7]. A delay in diagnosis appears to play a role in outcome, making early recognition and treatment critical [7].…”

Akute symptomatische Hyponatriämie bei einem 70-jährigen Patienten

“…Die postoperative Hyponatriämie durch eine inadäquate ADH-Freisetzung wurde nicht nur nach großen operativen Eingriffen, sondern auch nach minimal invasiven Operationen beobachtet [5]. Auch das Schädel-Hirn-Trauma kann eine inadäquate ADH-Sekretion induzieren.…”