Early detection of 'endometrial resection syndrome'

We report a patient who developed symptoms of fluid overload after having absorbed 3 litres of irrigating fluid during transcervical resection of the endometrium. Four methods were used to measure the absorption at 10-min intervals throughout the operation. There were strong intercorrelations between the results of these monitoring methods, which consisted in breath ethanol analyses and measurements of the serum sodium and glycine concentrations and of the volumetric fluid balance. However, the ethanol method was easiest to perform and provided immediate results. This monitoring gave the operating team as much as 45 min to prevent further absorption before it became large enough to elicit a transcervical endometrial resection syndrome.