Abstract
Kist hidatik rüptürü, anafilaktik şok hatta ölüme kadar ilerleyebilen, alerjik reaksiyonlara neden olabilir. Bu makalede, laparoskopik kist hidatik cerrahisine alınan kardiyak peysli hastada gelişen dirençli anafilaktik şok tablosunun yönetimi sunulmuştur. Laparoskopik cerrahi uygulanan bu olguda, ilk tablonun ani hipotansiyon ile ortaya çıkması, cilt döküntülerinin ve solunumsal belirtilerin geç görülmesi ayırıcı tanıyı zorlaştırmıştır. AV tam bloğa bağlı kardiyak peys varlığı, ST segment analizi ve taşi-bradikardi durumlarını değerlendirmemizi engellemiştir. Sonuç olarak, kist hidatik cerrahi sırasında belirgin makroskopik rüptür olmaksızın anafilaksi gelişebilir ve refrakter anafilaktik şoka yola açabilir. Komorbid hastalığı olan kardiyak hastalarda anafilaktik şokun tanınması ve yönetimi güç olabilir. Anafilaktik şokun erken tanınması ve tedavisinde erken intramusküler adrenalin uygulanması gerektiği unutulmamalıdır.
References
- Siracusano A, Teggi A, Ortona E. Human Cystic Echinococcosis: Old Problems And New Perspectives. Interdisciplinary Perspectives on Infectious Diseases. 2009;2009:1-7. Doi:10.1155/2009/474368
- Koçoğlu Barlas Ü, Akçay N, Petmezci Mt, Et Al. Anaphylaxis Due To Hydatid Cyst Rupture. Turkish Journal of Pediatric Emergency And Intensive Care Medicine. 2020;7(3):128- 131. Doi:10.4274/Cayd.Galenos.2020.02997
- Yilmaz F, Kaplan C, Nebi N. Anaphylaxis Due To Liver Hydatid Cyst During The Operation. Cyprus Journal Of Medical Sciences. Published Online September 19, 2018:112-113. Doi:10.5152/Cjms.2018.401
- Bhutani N, Kajal P. Hepatic Echinococcosis: A Review. Annals Of Medicine And Surgery. 2018;36:99. Doi:10.1016/J.Amsu.2018.10.032
- Kermenli T, Yalçınöz K, Polat Me. Intrathoracic Multiple Recurrence And Bilateral Endobronchial Rupture Of Cyst Hydatid Disease; The Rare Cause Of Anaphylaxis. Respir Med Case Rep. 2017;21:113-115. Doi:10.1016/J. Rmcr.2017.04.002
- Bostan H, Fikret Yücel A, Ali Şahin D, Üniversitesi Tıp Fakültesi R, Ve Reanimasyon Anabilim Dalı A, Cerrahi Anabilim Dalı G. Ameliyat Sırasında Oluşan Şokun Nadir Bir Sebebi: Karaciğer Hidatik Kist Rüptürüne Bağlı Anafilaksi. Olgu Sunumu Journal Surgical Arts, 2010;1:12- 15
- Belli S, Akbulut S, Erbay G, Kocȩr Ne. Spontaneous Giant Splenic Hydatid Cyst Rupture Causing Fatal Anaphylactic Shock: A Case Report And Brief Literature Review. Turkish Journal Of Gastroenterology. 2014;25(1):88-91. Doi:10.5152/Tjg.2014.3521
- Monsieurs, K. R. G., Nolan, J. P., Bossaert, L. L, et al . European Resuscitation Council Guidelines for Resuscitation 2015: Section 1. Executive summary. Resuscitation, 95, 1–80. Doi:10.1016/J.RESUSCITATION.2015.07.038
- Sanei, B., Hashemi, S.M. & Mahmoudieh, M. Anaphylactic Shock Caused by Nonruptured Hydatid Cyst of the Liver. J Gastrointest Surg 12, 2243–2245 (2008). Doi:10.1007/ s11605-008-0468-0
- Derici, H., Tansug, T., Reyhan, E. et al. Acute Intraperitoneal Rupture of Hydatid Cysts. World J. Surg. 30, 1879–1883 (2006). Doi:10.1007/s00268-005-0699-0
- Pedrosa I, Saíz A, Arrazola J, Ferreirós J, Pedrosa Cs. Hydatid Disease: Radiologic And Pathologic Features And Complications1. 2000;20(3):795-817. Doi:10.1148/ Radıographıcs.20.3.G00ma06795
- Alansari M, Alsanouri I. Atypical intraoperative anaphylactic shock with ECG changes secondary to nonruptured hepatic hydatid cyst. BMJ Case Rep. 2013 Jan 30;2013:bcr2012008442. doi: 10.1136/bcr-2012-008442. PMID: 23370961; PMCID: PMC3603538.
- Shaker MS, Wallace DV, Golden DBK, et al. Anaphylaxis-a 2020 practice parameter update, systematic review, and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) analysis. J Allergy Clin Immunol. 2020;145(4):1082-1123. doi:10.1016/j.jaci.2020.01.017
- Atlee, J. Complications in anesthesia. Complications in Anesthesia Second Edition (2007). İçinde: David G. Bjorake, Anaphylaxis and Anaphylactoid Reaction Chapter 27 2007:97-100 Doi:10.1016/B978-1-4160-2215-2.X5001- 7
- Tanno LK, Alvarez-Perea A, Pouessel G. Therapeutic approach of anaphylaxis. Curr Opin Allergy Clin Immunol. 2019 Aug;19(4):393-401. Doi:10.1097/ ACI.0000000000000539. PMID: 31058676.
- Lott C, Truhla ́r A, Alfonzo A, Barelli A, Gonza ́lez- Salvado V, Hinkelbein J, Nolan JP, Paal P et al. European Resuscitation Council Guidelines 2021: Cardiac arrest in special circumstances. Resuscitation 2021;161:152-219. Doi:10.1016/j.resuscitation.2021.02.011
- Garner, O., Ramey, J. S., & Hanania, N. A. (2022). Management of Life-Threatening Asthma: Severe Asthma Series. Chest, 162(4), 747–756. https://doi.org/10.1016/J. CHEST.2022.02.029
Abstract
Hydatid cyst rupture can cause allergic reactions that can progress to anaphylactic shock or even death. This article presents the management of resistant anaphylactic shock in a patient with cardiac pacing who underwent laparoscopic hydatid surgery. In this case, who underwent laparoscopic surgery, the initial presentation with sudden hypotension and the late appearance of skin rashes and respiratory symptoms made the differential diagnosis difficult. The presence of cardiac pace due to complete AV block prevented us from evaluating ST segment analysis and tachy-bradycardia. In conclusion, anaphylaxis may develop and can cause refractory anaphylactic shock without significant macroscopic rupture findings during hydatid surgery. Recognition and management of anaphylactic shock can be difficult in cardiac patients with comorbid diseases. It should not be forgotten that early intramuscular adrenaline should be administered in the early recognition and treatment of anaphylactic shock.
References
- Siracusano A, Teggi A, Ortona E. Human Cystic Echinococcosis: Old Problems And New Perspectives. Interdisciplinary Perspectives on Infectious Diseases. 2009;2009:1-7. Doi:10.1155/2009/474368
- Koçoğlu Barlas Ü, Akçay N, Petmezci Mt, Et Al. Anaphylaxis Due To Hydatid Cyst Rupture. Turkish Journal of Pediatric Emergency And Intensive Care Medicine. 2020;7(3):128- 131. Doi:10.4274/Cayd.Galenos.2020.02997
- Yilmaz F, Kaplan C, Nebi N. Anaphylaxis Due To Liver Hydatid Cyst During The Operation. Cyprus Journal Of Medical Sciences. Published Online September 19, 2018:112-113. Doi:10.5152/Cjms.2018.401
- Bhutani N, Kajal P. Hepatic Echinococcosis: A Review. Annals Of Medicine And Surgery. 2018;36:99. Doi:10.1016/J.Amsu.2018.10.032
- Kermenli T, Yalçınöz K, Polat Me. Intrathoracic Multiple Recurrence And Bilateral Endobronchial Rupture Of Cyst Hydatid Disease; The Rare Cause Of Anaphylaxis. Respir Med Case Rep. 2017;21:113-115. Doi:10.1016/J. Rmcr.2017.04.002
- Bostan H, Fikret Yücel A, Ali Şahin D, Üniversitesi Tıp Fakültesi R, Ve Reanimasyon Anabilim Dalı A, Cerrahi Anabilim Dalı G. Ameliyat Sırasında Oluşan Şokun Nadir Bir Sebebi: Karaciğer Hidatik Kist Rüptürüne Bağlı Anafilaksi. Olgu Sunumu Journal Surgical Arts, 2010;1:12- 15
- Belli S, Akbulut S, Erbay G, Kocȩr Ne. Spontaneous Giant Splenic Hydatid Cyst Rupture Causing Fatal Anaphylactic Shock: A Case Report And Brief Literature Review. Turkish Journal Of Gastroenterology. 2014;25(1):88-91. Doi:10.5152/Tjg.2014.3521
- Monsieurs, K. R. G., Nolan, J. P., Bossaert, L. L, et al . European Resuscitation Council Guidelines for Resuscitation 2015: Section 1. Executive summary. Resuscitation, 95, 1–80. Doi:10.1016/J.RESUSCITATION.2015.07.038
- Sanei, B., Hashemi, S.M. & Mahmoudieh, M. Anaphylactic Shock Caused by Nonruptured Hydatid Cyst of the Liver. J Gastrointest Surg 12, 2243–2245 (2008). Doi:10.1007/ s11605-008-0468-0
- Derici, H., Tansug, T., Reyhan, E. et al. Acute Intraperitoneal Rupture of Hydatid Cysts. World J. Surg. 30, 1879–1883 (2006). Doi:10.1007/s00268-005-0699-0
- Pedrosa I, Saíz A, Arrazola J, Ferreirós J, Pedrosa Cs. Hydatid Disease: Radiologic And Pathologic Features And Complications1. 2000;20(3):795-817. Doi:10.1148/ Radıographıcs.20.3.G00ma06795
- Alansari M, Alsanouri I. Atypical intraoperative anaphylactic shock with ECG changes secondary to nonruptured hepatic hydatid cyst. BMJ Case Rep. 2013 Jan 30;2013:bcr2012008442. doi: 10.1136/bcr-2012-008442. PMID: 23370961; PMCID: PMC3603538.
- Shaker MS, Wallace DV, Golden DBK, et al. Anaphylaxis-a 2020 practice parameter update, systematic review, and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) analysis. J Allergy Clin Immunol. 2020;145(4):1082-1123. doi:10.1016/j.jaci.2020.01.017
- Atlee, J. Complications in anesthesia. Complications in Anesthesia Second Edition (2007). İçinde: David G. Bjorake, Anaphylaxis and Anaphylactoid Reaction Chapter 27 2007:97-100 Doi:10.1016/B978-1-4160-2215-2.X5001- 7
- Tanno LK, Alvarez-Perea A, Pouessel G. Therapeutic approach of anaphylaxis. Curr Opin Allergy Clin Immunol. 2019 Aug;19(4):393-401. Doi:10.1097/ ACI.0000000000000539. PMID: 31058676.
- Lott C, Truhla ́r A, Alfonzo A, Barelli A, Gonza ́lez- Salvado V, Hinkelbein J, Nolan JP, Paal P et al. European Resuscitation Council Guidelines 2021: Cardiac arrest in special circumstances. Resuscitation 2021;161:152-219. Doi:10.1016/j.resuscitation.2021.02.011
- Garner, O., Ramey, J. S., & Hanania, N. A. (2022). Management of Life-Threatening Asthma: Severe Asthma Series. Chest, 162(4), 747–756. https://doi.org/10.1016/J. CHEST.2022.02.029
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Emergency Medicine, Intensive Care |
| Journal Section | Case Reports |
| Authors | |
| Publication Date | December 29, 2022 |
| Published in Issue | Year 2022 Volume: 1 Issue: 3 |
