Acute Hyponatremic Encephalopathy after Ingestion of Polyethylene Glycol Solution before Colonoscopy / 대한소화기내시경학회지

ABSTRACT

Preparation for colonoscopy involves a thorough cleansing of the large bowel. Cleansing is performed using several methods, including ingestion of 4 liters of polyethylene glycol solution. However, these methods can induce hyponatremia by various mechanisms. Severe or rapidly progressing hyponatremia can result in the swelling of the brain, and the symptoms of hyponatremia are mainly neurological. Recently, we encountered a 41-year-old woman who developed acute hyponatremia with encephalopathy after undergoing bowel preparation for colonoscopy. She presented with general weakness, nausea, headache, agitation, delusions, and slurred speech one day after the ingestion of polyethylene glycol solution. Her serum sodium level was very low (110 to 115 mEq/L). Her symptoms pertaining to hyponatremia continued to persist for more than 2 days despite continuous intravenous administration of hypertonic saline for the correction of hyponatremia.