Approach to the patient - disorders of salt and water balance post pituitary surgery.

Transsphenoidal surgery (TSS) is the first line treatment for many clinically significant pituitary tumors and sellar lesions. Although complication rates are low when performed at high-volume centers, disorders of salt and water balance are relatively common post-operatively. Both, or either, central diabetes insipidus (DI), caused by a deficiency in production and/or secretion of arginine vasopressin (AVP), and hyponatremia, most commonly secondary to the syndrome of inappropriate antidiuresis (SIAD), may occur. These conditions can extend hospital stay and increase the risk of readmission. This article discusses common presentations of salt and water balance disorders following pituitary surgery, the pathophysiology of these conditions and their diagnosis and management.