Korean Journal of Gastrointestinal Endoscopy 2008;37(4): 303-307.
건강한 성인에서 Sulfate Free Polyethylene Glycol로 대장내시경 전처치 후 발생한 저나트륨혈증 1예
옥경선ㆍ김유선ㆍ장원철ㆍ정태엽ㆍ허진국ㆍ류수형ㆍ이정환ㆍ문정섭
인제대학교 의과대학 서울백병원 내과학교실
Hyponatremic Encephalopathy Following a Sulfate Free Polyethylene Glycol-based Bowel Preparation for Colonoscopy
Kyung Sun Ok, M.D., You Sun Kim, M.D., Won Cheol Jang, M.D., Tae Yeob Jeong, M.D., Jin Gook Huh, M.D., Soo Hyung Ryu, M.D., Jung Hwan Lee, M.D. and Jeong Seop Moon, M.D.
Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
Abstract
Hyponatremia associated with the use of both a sodium phosphate (NaP) and polyethylene glycol (PEG) solution for colonoscopy preparation has been reported in patients with impaired renal handling of water. A PEG solution is believed to affect serum electrolytes less than NaP, but the use of a PEG solution can lead to nausea, vomiting, intestinal hyperactivity and dehydration, often resulting in a raised plasma antidiuretic hormone (ADH) concentration. Non-osmolar stimuli such as pain, stress, nausea, and vomiting can stimulate ADH release. We report a case of severe hyponatremic encephalopathy after sulfate-free PEG ingestion for a colonoscopy in a healthy middle-aged woman. We think that physicians should be familiar with the medical history and current medication schedule of patients prior to bowel preparation. The levels of serum electrolytes should be checked in patients with impaired ability to excrete free water and any mental aberrations before undertaking colonoscopy procedures. (Korean J Gastrointest Endosc 2008;37:303-307)
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