Ureteral injury presenting with hyponatremia.

Abstract

Ureteral injuries in gynecologic surgery, although rare, classically present with a well-described constitution of symptoms. Hyponatremia in association with ureteral injury has not been described. A 44-year-old multiparous woman presented with chronic pelvic pain and a persistent adnexal mass underwent exploratory laparotomy, lysis of adhesions, and left salpingo-oophorectomy. On postoperative day 5, she demonstrated classic signs and symptoms of ureteral obstruction. In addition, she developed hyponatremia with a serum sodium concentration of 124 mEq/L that immediately resolved after percutaneous drainage of the urinoma. Hyponatremia may develop with untreated and unrecognized ureteral injuries. Serum electrolytes may be helpful in the evaluation of suspected ureteral injury.