Case report: Intravascular absorption syndrome in hysteroscopy, glycine intoxication

Quispe-Pilco E.R.; Calderón-Lozano M.L.; León-Castillo J.P.; Gómez-Huarachi G.A. · Revista Chilena de Obstetricia y Ginecologia (2023) · DOI: 10.24875/rechog.23000011

Resumen

Intravascular absorption syndrome in hysteroscopy is caused by rapid vascular absorption of isotonic and hypotonic solutions used in intrauterine irrigation, causing hypervolemia and electrolyte dilution, especially hyponatremia. When this syndrome is due to 1.5% glycine toxicity, it causes severe acidosis and neurotoxicity. The incidence of this syndrome is low but may increase due to factors such as: lack of control of the height of irrigation bags, lack of fluid balance in irrigation solutions, highly vascularized tissues such as uterine myomas and use of a monopolar electrosurgery system. The case of a patient with uterine myomas, scheduled for resection by hysteroscopy, who presents with intravascular glycine absorption syndrome, is reported. Early diagnosis and rapid intraoperative and postoperative treatment allowed a favorable evolution. Management was based on the use of diuretics, fluid restriction, and hypertonic sodium solutions.

Instituciones: Universidad Nacional Mayor de San Marcos