Abstract：
We report a case of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) after total proctocolectomy followed with ileal pouch-anal anastomosis (TPC-IPAA) for ulcerative colitis (UC). The patient was a 46-year-old woman. She was diagnosed with UC of pancolitis in 2000. High grade dysplasia was detected in the transverse colon after a surveillance colonoscopy in 2021. She underwent laparoscopy-assisted TPC-IPAA. On the sixth postoperative day, she had a decreased level of consciousness that worsened on the following day. Her laboratory data showed a serum sodium level of 108 mEq/L and the plasma osmolality was 234 mOsm/kg. We did not find any other abnormalities in the laboratory examination that could cause hyponatremia. Computed tomography scan showed no central nervous system disturbances such as a pituitary tumor, antidiuretic hormone-producing tumors, or pulmonary diseases. The patient was diagnosed with Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by surgical invasion. We started to administer 3% sodium chloride slowly to improve the hyponatremia. Her serum sodium level became normal and stable. Although it is rare for SIADH to be caused by abdominal surgery, if hyponatremia is observed after surgery, the possibility of postoperative SIADH should be considered.
摘要：
我们报告了一例溃疡性结肠炎（UC）的全直肠结肠切除术后回肠袋肛门吻合术（TPC-IPAA）后抗利尿激素（SIADH）分泌不当综合征。患者是一名46岁的女性。她在2000年被诊断为UC为泛结肠炎。2021年进行结肠镜检查后，在横结肠中发现了高度异型增生。她接受了腹腔镜辅助TPC-IPAA。术后第六天,她的意识水平下降，第二天恶化了。她的实验室数据显示血清钠水平为108mEq/L，血浆渗透压为234mOsm/kg。我们在实验室检查中没有发现任何其他可能导致低钠血症的异常。计算机断层扫描显示没有中枢神经系统紊乱，如垂体瘤，产生抗利尿激素的肿瘤，或肺部疾病。患者被诊断为手术侵袭引起的抗利尿激素分泌不当综合征（SIADH）。我们开始缓慢服用3%氯化钠来改善低钠血症。她的血清钠水平变得正常和稳定。虽然SIADH很少是由腹部手术引起的，如果手术后观察到低钠血症，应考虑术后SIADH的可能性.
