Operative hysteroscopy intravascular absorption syndrome: A case report and literature review

Abstract

Background

Operative hysteroscopy intravascular absorption syndrome is a little-known disease traditionally caused by the use of a hypo-osmolar distension fluid during hysteroscopic surgery. Symptoms of OHIA syndrome include pulmonary and cerebral edema, hyponatremia, and metabolic acidosis. Preventive measures include the use of a bipolar current, NaCl 0.9 ​%, and limiting positive fluid balance to 1000 ml.

Case report

This paper describes the curious case of a middle-aged patient who presented to our emergency department with eye congestion, anasarca, and pulmonary edema following hysteroscopy, despite using NaCl 0.9 ​% as a distension fluid. Only a few cases have been reported in the literature, and it appears that the use of glycine instead of NaCl 0.9 ​% does not lead to the same complications. To better handle these situations, this article provides treatment suggestions and preventive measures through a literature review to help physicians to rapidly detect and manage this potentially life-threatening syndrome.

Why Should an Emergency Physician Be Aware of This ? - OHIA syndrome can be life-threatening and may manifest with various complications, requiring different management approaches and complementary examinations depending on the distension fluid used by the surgeon. Physicians should be knowledgeable about this lesser-known syndrome in order to effectively prevent, diagnose, and treat it.