[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-454778-105":3,"detail-sidebar-cat-0-en-105":72,"doc-detail-454778-en":122},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":65,"head_meta":67,"extra_data":69,"updated_unix":71},105,"en","unmasking-the-culprit-of-profound-hyponatremia-in-an-infant","Unmasking the Culprit of Profound Hyponatremia in an Infant","","Infants with severe hyponatremia (Na \u003C 120) and an abdominal mass require careful, rapid assessment because the condition may represent a medical emergency. The article reports a 2-month-old full-term female with two days of reduced oral intake and urine output, progressive abdominal distention, severe hyponatremia, and signs consistent with urinary tract infection and obstructive uropathy. Imaging identified a pelvic cystic mass ultimately explained by hydrometrocolpos due to distal vaginal obstruction. Urgent surgery and standard PICU supportive care led to marked symptom improvement and prevention of further complications.",{"@graph":14,"@context":64},[15,34,55],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/unmasking-the-culprit-of-profound-hyponatremia-in-an-infant/454778/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/unmasking-the-culprit-of-profound-hyponatremia-in-an-infant/454778.png","ImageObject",300,407,{"name":42,"@type":43},"Chumphorn","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-07","2026-09-30",true,{"@type":52,"interactionType":53,"userInteractionCount":26},"InteractionCounter",{"@type":54},"ViewAction",{"@type":56,"mainEntity":57},"FAQPage",[58],{"name":59,"@type":60,"acceptedAnswer":61},"How was the patient treated and what was the outcome?","Question",{"text":62,"@type":63},"She received saline and hypertonic saline for resuscitation, antibiotics (ceftriaxone) for presumed UTI, urinary decompression with a Foley catheter, and surgical incision and reconstruction of an imperforate hymen, resulting in over 350 cc of drainage and gradual electrolyte improvement with discharge after 3 days.","Answer","https://schema.org",{"og:url":32,"og:type":66,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":68,"canonical":32},"index,follow",{"doc_id":70,"site_id":7},454778,1790741329,{"code":4,"msg":73,"data":74},"success",[75,79,83,87,92,97,101,106,111,114,118],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":76,"show_sort_weight":77,"slug":78},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":80,"show_sort_weight":81,"slug":82},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":84,"show_sort_weight":85,"slug":86},"Exam",70,"exam",{"id":88,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},5,"Comic",60,"comic",{"id":93,"doc_module":4,"doc_module_name":25,"category_name":94,"show_sort_weight":95,"slug":96},6,"Technology",50,"technology",{"id":98,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":99,"slug":100},7,40,"healthcare",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},8,"Research & Report",30,"research-report",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":108,"show_sort_weight":109,"slug":110},9,"Religion & Spirituality",20,"religion-spirituality",{"id":109,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":109,"slug":113},"World Cup","world-cup",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":115,"slug":117},10,"Lifestyle","lifestyle",{"id":119,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":88,"slug":121},19,"General","general",{"code":4,"msg":73,"data":123},{"doc_id":70,"user_id":124,"nickname":42,"user_avatar":125,"doc_module":4,"category_id":98,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":126,"file_id":127,"file_url":128,"file_type":129,"file_size":130,"view_count":26,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":33,"language":131,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":132,"faqs":133,"seo_title":134,"seo_description":12,"update_tm":71,"read_time":115,"preview_page_count":4},2336475401981,"https://ap-avatar.wpscdn.com/avatar/22000c94efd8d5204d?x-image-process=image/resize,m_fixed,w_180,h_180&k=1786935347598174694","Wiley  \nCase Reports in Pediatrics  \nVolume 2026, Article ID 4883190, 4 pages [https://doi.org/10.1155/crpe/4883190](https://doi.org/10.1155/crpe/4883190)  \nCase Report  \nUnmasking the Culprit of Profound Hyponatremia in an Infant  \nBayan Matarneh , 1 Richard Johnson , 1 and Jamie Bell 1,2  \n1 Department of Pediatrics, Children’s Hospital of Michigan, Detroit, Michigan, USA  \n2 College of Medicine, Central Michigan University, Mount Pleasant, Michigan, USA  \nCorrespondence should be addressed to Jamie Bell; [jbell@dmc.org](jbell@dmc.org)  \nReceived 3 April 2025; Revised 21 November 2025; Accepted 19 December 2025  \nAcademic Editor: Nikhat Kaura  \nCopyright © 2026 Bayan Matarneh et al. Case Reports in Pediatrics published by John Wiley & Sons Ltd. Tis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.  \nInfants with severe hyponatremia (Na \u003C 120) and an abdominal mass require an astute clinical evaluation and often represent a medical emergency. We report a case of a 2-month-old White female, born full term, presenting with a two-day history of decreased oral intake and urinary output, who was found to have severe hyponatremia with notable abdominal distention. Abdominal imaging revealed the presence of a pelvic mass causing obstructive uropathy. Further imaging and urogenital examination revealed a hydrometrocolpos. Tis rare entity required urgent surgical intervention and standard supportive care in the PICU. She had a subsequent signifcant improvement in symptoms and prevention of further deleterious complications.  \n1. Introduction  \nAbdominal distention in infants often presents a distressing challenge in the emergency room, as etiologies range from benign to malignant, with few distinguishing signs on examination. Timely diagnosis and management are crucial to prevent complications. An unusual cause of infantile abdominal distention is hydrometrocolpos—a rare condition characterized by fuid accumulation in the vagina (hydrocolpos) and/or uterus (hydrometra), typically due to distal vaginal obstruction [1]. Tis condition can lead to the formation of a compressive mass, resulting in complications such as hydroureteronephrosis, electrolyte imbalance, urinary tract infections (UTIs), and increased risk of sepsis and endorgan damage. A high level of suspicion is required in this patient population to enable earlier diagnosis and prompt surgical intervention to prevent serious complications [2].  \n2. Case Presentation  \nA 2-month-old female infant, born full term at 41 weeks, presented to the emergency room with oliguria and decreased oral intake for two days, along with progressive abdominal distention and emesis. Te baby was fed only by direct breastfeeding, and the parents denied any other forms  \nof water or fuid supplementation. Te family reported no fever, trauma, or antecedent infections. She did have a normal newborn screen after birth.  \nIn the emergency room, vital signs showed a weight of 7.4 kg, temperature of 38.2°C, heart rate of 156 beats/min, respiratory rate of 70 breaths per minute, and blood pressure of 93/56 mmHg. Te physical exam showed a tired but alert baby, well-nourished with no dysmorphic features. Te cardiorespiratory exam was signifcant for tachypnea, mild retractions, and diminished perfusion, with a capillary refll time of > 3 s. Te abdomen was soft, difusely tender with notable abdominal distention, and no organomegaly. She had normal female external genitalia. Laboratory results revealed severe hyponatremia (direct sodium level of 111 mmol/L), hyperkalemia (7.2 mmol/L), acute kidney injury with elevated creatinine (0.5), a blood urea nitrogen (BUN) of 33, and nonanion gap (AG of 13) metabolic acidosis (bicarbonate of 10) . Urinalysis tested positive for blood, protein, and leukocyte esterase, and serum WBC was elevated at 43,000, consistent with UTI. Ma","cbCaip5JHULQGoSz","https://ap.wps.com/l/cbCaip5JHULQGoSz","pdf",815523,"English","# Introduction\n## Hydrometrocolpos and its clinical significance\n# Case Presentation\n## Presentation, initial evaluation, and imaging\n## Resuscitation, ICU care, and surgical management\n## Laboratory findings and follow-up\n# Discussion","[{\"question\":\"How was the patient treated and what was the outcome?\",\"answer\":\"She received saline and hypertonic saline for resuscitation, antibiotics (ceftriaxone) for presumed UTI, urinary decompression with a Foley catheter, and surgical incision and reconstruction of an imperforate hymen, resulting in over 350 cc of drainage and gradual electrolyte improvement with discharge after 3 days.\"}]","Unmasking the Culprit of Profound Hyponatremia in an Infant | PDF"]