Acute Hyponatremia as a Telling Complication of Necrotizing Pancreatitis and Perforated Cholecystitis After Percutaneous Cholecystostomy

Acute hyponatremia is an uncommon complication of percutaneous cholecystostomy drainage with minimal literature to date. We present a case of a patient with necrotizing pancreatitis causing perforated cholecystitis, requiring percutaneous cholecystostomy that was complicated by acute hyponatremia. High biliary solute and volume loss led to the hyponatremia and elucidated downstream biliary obstruction. Fluid resuscitation, biliary stenting, and endoscopic drainage corrected the patient's sodium and symptoms in this multidisciplinary case.