Question

During a hysteroscopic removal of a submucosal fibroid, a fluid deficit of 2000 mL is estimated in a patient. What is the immediate complication of this?

• A. Acute tubular necrosis
• B. DIC
• C. Pulmonary edema
• D. Thromboembolism

Answer 1

The Correct Option is C

In a hysteroscopic procedure, a large fluid balance deficit can lead to fluid overload complications such as pulmonary edema. Pulmonary edema occurs when fluid accumulates in the lungs, making it challenging for the patient to breathe and ensuring decreased oxygen supply. This condition is immediately associated with excessive absorption of the distending medium used during the procedure, leading to an overload in the circulatory system. Here's how it happens:

• Fluid Absorption: While using fluid mediums in hysteroscopy to distend the uterine cavity, some fluid can be absorbed systemically.
• Fluid Overload: If the absorption exceeds a normal threshold (such as a 2000 mL deficit), it may overwhelm the body's ability to manage the excess fluid.
• Pulmonary Edema Development: The excess fluid enters the vascular circulation and can seep into the alveolar spaces in the lungs, leading to difficulties in gas exchange and respiratory distress.

Therefore, the immediate complication related to a fluid deficit during a hysteroscopic removal of a fibroid is pulmonary edema.