Operative hysteroscopy intravascular absorption syndrome – a life-threatening complication
  • Tiago Neto Gonçalves
    Serviço de Medicina Interna, Hospital da Luz Lisboa, Lisbon, Portugal; Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
  • João Galaz Tavares
    Serviço de Medicina Interna, Hospital da Luz Lisboa, Lisbon, Portugal https://orcid.org/0000-0002-5395-5236
  • Natália Marto
    Serviço de Medicina Interna, Hospital da Luz Lisboa, Lisbon, Portugal
  • Cláudia Diogo
    Serviço de Medicina Intensiva, Hospital da Luz Lisboa, Lisbon, Portugal
  • António Messias
    Serviço de Medicina Intensiva, Hospital da Luz Lisboa, Lisbon, Portugal

Keywords

Hysteroscopy, pulmonary oedema, fluid overload, iatrogenesis

Abstract

Operative hysteroscopy intravascular absorption (OHIA) syndrome is a rare and potentially life-threatening complication related to irrigation fluid systemic absorption during hysteroscopy. It can lead to severe electrolyte disturbances, cerebral and pulmonary oedema, dysrhythmias and coagulopathy. We present the case of a 30-year-old woman who underwent a hysteroscopic myomectomy. After absorbing 2.5 l of normal saline, she experienced haemodynamic instability, respiratory distress and severe metabolic acidosis, initially mistaken for an anaphylactic or haemorrhagic shock. Insufficient monitoring of fluid deficit and irrigation fluid pressures contributed to the condition. This case underscores the importance of recognising OHIA and its risk factors to enable timely intervention and prevent adverse outcomes. Close fluid balance monitoring is vital in hysteroscopic surgeries to mitigate OHIA development.

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    Published: 2023-10-25
    Issue: 2023: Vol 10 No 11 (view)

    How to cite:
    1.
    Neto Gonçalves T, Galaz Tavares J, Marto N, Diogo C, Messias A. Operative hysteroscopy intravascular absorption syndrome – a life-threatening complication. EJCRIM 2023;10 doi:10.12890/2023_004132.

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