The Turkish Journal of Pediatrics
2012 , Vol 54 , Num 4
Iatrogenic water intoxication during pelvic ultrasonography in a patient with diabetes insipidus
Departments of 1Pediatric Emergency, 2Pediatric Endocrinology, and 3Pediatric Critical Care, Gazi University Faculty of
Medicine, Ankara, Turkey. E-mail: oderinoz@gazi.edu.tr
Pelvic ultrasonography (US) is a simple and non-invasive radiologic test to
evaluate the pelvic organs. It requires a full bladder for better visualization.
Our case is a 14-year-old female with diabetes insipidus (DI) who admitted to
the pediatric emergency service with the complaints of seizure and agitation
after drinking 4 liters of water in one hour for a pelvic US examination due to
work-up for delayed puberty. Her biochemical and clinical evaluation revealed
water intoxication (WI). To our knowledge, this is the first WI case developed
in a patient with DI. Here, we discuss the underlying factors leading to this
complication and recommended an approach to obtain a better sonographic
image without necessitating oral water intake to fill the urinary bladder.
Keywords :
child, diabetes insipidus, hyponatremia, water intoxication.