Abstract
A rare case of the syndrome of inappropriate antidiuretic hormone secretion occuring after minor surgery is presented. A ten-year-old, previously healthy boy underwent general anaesthesia for detorsion and right orchiopexy. Throughout the operations, which lasted for one hour, he received 120 ml Ringer’s lactate solution. The immediate postoperative period was uneventful. Twenty-two hours postoperatively he was found unconscious with generalized tonic-clonic seizures. Simultaneously obtained serum sodium concentration (121 mEq · L−1) serum osmolarity (265 mEq · L−1), urine sodium concentration (87 mEq · L−1) and urine osmolarity (525 mEq · L−1) suggested inappropriate antidiuretic hormone secretion which was confirmed by an elevated serum arginine-vasopresin (AVP) level of 14.5 pcg · ml−1 (normal 1–5 pcg · ml−1) measured by radioimmune assay. He was treated with a single iv dose of 30 mg furosemide and fluid restriction, which produced a gradual increase of his serum sodium concentration to normal within two days. He was well during the remainder of his hospitalization.
Résumé
On présente un rare cas d’ un syndrome de sécrétion inappropriee d’ hormone antidiurétique survenant après chirurgie mineure. Un enfant en bonne santé âgé de dix ans a subi l’ anesthésie générale pour détorsion et orchiopexie droite. Durant l’opération qui a durée une heure, il a reçu 120 ml de lactate Ringer. La période postopératoire fut sans complication. Vingt-deux heures après l’ opération, l’ enfant fut trouvé inconscient avec. des convulsions généralisées cloniques-toniques. La concentration simultanée de sodium sérique (121 mEq · L−1), l’osmolarité sérique (265 mEq · L−1), la concentration sodique d’ urine (87 mEq · L−1) et l’ osmolarité urinaire (525 mEq · L−1) out suggéré le syndrome de sécrétion inappropriée d’ hormone antidiurétique qui fut confirmé par l’ élévation de la concentration sérique de l’ arginine-vasopressine (AVP) de 14.5 peg · ml−1 (normle 1–5 peg · ml−1) mesurée par radioimmunoessai. Il fut traité par une dose intraveineuse unique de 30 mg de furosémide et la restriction hydrique qui amena graduellement une augmentation de la concentration du sodium sérique a la normale en dedans de deux jours. Il se sentait bien durant de son hospitalisation.
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Soroker, D., Ezri, T., Lurie, S. et al. Symptomatic hyponatraemia due to inappropriate antidiuretic hormone secretion following minor surgery. Can J Anaesth 38, 225–226 (1991). https://doi.org/10.1007/BF03008151
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DOI: https://doi.org/10.1007/BF03008151