Anaphylactic shock during cholecystectomy surgery with retrograde cholangiopancreatography: case report
DOI:
https://doi.org/10.37497/JMRReview.v2i1.32Keywords:
Anaphylaxis, Allergic Reaction, Surgery, AnesthesiologyAbstract
Background: Anaphylactic shock (AS), also known as anaphylaxis, is a serious acute multisystemic reaction, resulting from the release of a multitude of inflammatory mediators, which culminates in respiratory, cardiovascular and mucocutaneous manifestations that are often fatal. Unfortunately, despite many advances in understanding the etiology, etiopathogenic mechanisms and management, AS remains underdiagnosed and undertreated.
Aim: To report a case of AS during cholecystectomy surgery with retrograde cholangiopancreatography. Method: This is a case report of a patient treated at the Hospital Universitário São Francisco na Providência de Deus, located in Bragança Paulista – SP, Brazil.
Case Report: This was a 37-year-old female patient who was admitted for a laparoscopic cholecystectomy with cholangiopancreatography due to symptomatic cholelithiasis and choledocholithiasis. During surgery, after the introduction of an orogastric tube where there was contact between the oral mucosa and a latex glove, the patient presented an increase in heart rate, a drop in oxygen saturation, severe hypotension, hyperemia and urticarial plaques, probably suggesting anaphylactic shock. due to the glove material. Adrenaline and other supplies were administered and, with the condition stabilizing, cholecystectomy was performed and cholangiopancreatography (ERCP) was postponed. The patient was transferred to the intensive care unit, where she recovered. Despite negative IgE tests to latex, the patient's history and the nature of her occupational exposure to the material led to the suspicion of allergy to the material, and precautionary measures were adopted to perform ERCP without latex, with discharge occurring on the day next, without complications.
Conclusion: Based on the evidence presented, it is highly likely that the reported allergic reaction to latex was triggered by prior occupational exposure to the material. This highlights the importance of latex allergy screening, especially in patients with a history of repeated exposure to the material, in order to prevent potentially serious allergic reactions during surgical procedures.
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