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[Severe hyponatremia and comatose state during colonoscopy preparation]
Agnes Haris1, Pál Demeter, Ignác Tóth
1Fovárosi Onkormányzat Szent János Kórháza és Eszak-budai Egyesített Kórházai, Szent Margit Kórház, Nefrológia Osztály, Budapest Bécsi út 132. 1032. agnesharis@hotmail.com
Orvosi Hetilap
|May 6, 2010
Summary
Severe hyponatremia can occur during colonoscopy preparation due to excessive fluid intake and stress. Prompt treatment with hypertonic saline successfully resolved the electrolyte imbalance and improved patient outcomes.
Area of Science:
- Internal Medicine
- Gastroenterology
Background:
- Colonoscopy preparation involves bowel cleansing, often with purgatives like sodium phosphate.
- Patient adherence to instructions, including fluid intake, is crucial for effective preparation.
Observation:
- An 83-year-old female experienced sudden unconsciousness and seizures during bowel preparation for colonoscopy.
- She had not yet ingested the sodium phosphate purgative but had consumed excessive fluids.
- Laboratory results revealed severe hyponatremia (low sodium levels).
Findings:
- The patient's symptoms were attributed to acute hyponatremia, likely triggered by stress-induced antidiuretic hormone (ADH) secretion and excessive fluid intake.
- Treatment with hypertonic saline infusion corrected the electrolyte disturbance.
Implications:
- This case highlights the potential risks associated with colonoscopy preparation, particularly excessive fluid intake and psychological stress.
- It underscores the importance of clear patient instructions and awareness of potential complications like hyponatremia.
- Prompt recognition and management of acute hyponatremia are essential for favorable patient outcomes.
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