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Case Report
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| Postoperative persistent hyponatremia: A case with metastatic lung cancer | ||||||
| Sibel Ocak Serin1, Gulsah Karaoren2, Ezgi Ersoy Yesil3, Hakan Cakit4, Sema Ucak Basat5 | ||||||
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1MD, Istanbul Umraniye Training and Research Hospital, Turkiye, Department of Internal Medicine.
2MD, Istanbul Umraniye Training and Research Hospital, Turkiye, Department of Anaesthesiology and Reanimation. 3MD, Istanbul Umraniye Training and Research Hospital, Turkiye, Division of Nephrology. 4Istanbul Umraniye Training and Research Hospital, Turkiye, Department of General Surgery. 5Proffesor, Istanbul Umraniye Training and Research Hospital, Turkiye, Department of Internal Medicine. | ||||||
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| How to cite this article |
| Serin SO, Karaoren G, Yesil EE, Cakit H, Basat SU. Postoperative persistent hyponatremia: A case with metastatic lung cancer. Int J Case Rep Images 2016;7(8):514–518. |
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Abstract
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Introduction:
Hyponatremia is most commonly encountered electrolyte disorder in clinical practice. Syndrome of inappropriate anti-diuretic hormone secretion (SIADH), most frequent cause of euvolemic hyponatremia, is an important element that increases risk for morbidity and mortality and indicates severity of primary disease. SIADH can be seen in many clinical conditions or as multifactorial.
Case Report: A 64-years old male presented to our facility emergency department with the complaints of shortness of breath and abdominal pain. According to the assessment, Morgagni hernia was in the thoracic and abdominal computed tomography (CT). The patient was hospitalized in the general surgery service and taken to the operation for hernia repair. On day-2 after operation, he had low serum Na+ value (124 mEq/L [124 mmol/L]). Serum Na+ value decreased to 114 mEq/L (114 mmol/L) on day 5 whereas 110 mEq/L (110 mmol/L) on the day-6; thus, 3% NaCl infusion was initiated. In further evaluation, several etiological factors were evaluated. On abdominal sonography, multiple metastatic lesions were detected incidentally. Thoracic and abdominal CT scan was re-evaluated, On thoracic CT scan, diffuse thickening (up to 1–1.5 cm) with irregular contours were observed. While isodense and hypodense lesions were seen in liver on abdominal CT scan. Diffuse metastatic disease was found in the patient by positron emission tomography (PET) scan and magnetic resonance imaging (MRI) scan. Small cell lung cancer (SCLC) diagnosis was made by biopsy samples obtained from liver. Our case had asymptomatic clinical course despite presence of diffuse metastatic SCLC and rapid decrease in Na+ values. Conclusion: Our case was presented to emphasize importance of detailed evaluation for all causes of SIADH, mainly malignancies in hospitalized patients at geriatric age group, and treatment based on differential diagnosis in the management of SIADH. | |
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Keywords:
General surgery, Hyponatremia, Small cell lung cancer, Syndrome of inappropriate anti-diuretic hormone secretion
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Author Contributions
Sibel Ocak Serin – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Gulsah Karaoren – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published Ezgi Ersoy Yesil – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published Hakan Cakit – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published Sema Ucak Basat – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© 2016 Sibel Ocak Serin et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information. |
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