Angioedema: Perioperative management
Objective: To describe the perioperative management of a patient with acquired angioedema (AAE). Methods: A 66-year-old Caucasian male presented from an outside hospital with a history of acquired angioedema and gastrointestinal stromal tumor–related intractable urticaria and mastocytosis. He was ad...
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Online Access: | https://doi.org/10.1177/2050313X17713912 |
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doaj-bbb2dd745c084e9cb1c4e5b684d77d642020-11-25T03:39:18ZengSAGE PublishingSAGE Open Medical Case Reports2050-313X2017-06-01510.1177/2050313X17713912Angioedema: Perioperative managementAndrew A Maynard0Christina F Burger1Joseph J Schlesinger2Department of Anesthesiology and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, USACollege of Pharmacy, The University of Tennessee, Memphis, TN, USADepartment of Anesthesiology and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, USAObjective: To describe the perioperative management of a patient with acquired angioedema (AAE). Methods: A 66-year-old Caucasian male presented from an outside hospital with a history of acquired angioedema and gastrointestinal stromal tumor–related intractable urticaria and mastocytosis. He was admitted for urgent laparoscopic partial gastrectomy, secondary to gastric outlet obstruction symptomatology. Previous combined attacks were characterized by a widespread rash, abdominal pain and respiratory distress resulting in hospitalization. Following preoperative consultation with the patient’s allergist and a hospital pharmacist, he was treated preoperatively with fresh frozen plasma and his home prednisone dose. C1-inhibitor (Berinert®) was on standby along with epinephrine, given that the underlying etiology (C1- inhibitor deficiency vs histaminergic) was not known. Results: There were no intraoperative complications, and the patient was discharged home 3 days after the procedure. Conclusions: Optimization of perioperative outcomes in patients, especially during urgent or emergent surgery, with a history of angioedema requires the development of a patient-specific perioperative plan, including prophylaxis, rescue therapies and opioid-sparing strategies.https://doi.org/10.1177/2050313X17713912 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Andrew A Maynard Christina F Burger Joseph J Schlesinger |
spellingShingle |
Andrew A Maynard Christina F Burger Joseph J Schlesinger Angioedema: Perioperative management SAGE Open Medical Case Reports |
author_facet |
Andrew A Maynard Christina F Burger Joseph J Schlesinger |
author_sort |
Andrew A Maynard |
title |
Angioedema: Perioperative management |
title_short |
Angioedema: Perioperative management |
title_full |
Angioedema: Perioperative management |
title_fullStr |
Angioedema: Perioperative management |
title_full_unstemmed |
Angioedema: Perioperative management |
title_sort |
angioedema: perioperative management |
publisher |
SAGE Publishing |
series |
SAGE Open Medical Case Reports |
issn |
2050-313X |
publishDate |
2017-06-01 |
description |
Objective: To describe the perioperative management of a patient with acquired angioedema (AAE). Methods: A 66-year-old Caucasian male presented from an outside hospital with a history of acquired angioedema and gastrointestinal stromal tumor–related intractable urticaria and mastocytosis. He was admitted for urgent laparoscopic partial gastrectomy, secondary to gastric outlet obstruction symptomatology. Previous combined attacks were characterized by a widespread rash, abdominal pain and respiratory distress resulting in hospitalization. Following preoperative consultation with the patient’s allergist and a hospital pharmacist, he was treated preoperatively with fresh frozen plasma and his home prednisone dose. C1-inhibitor (Berinert®) was on standby along with epinephrine, given that the underlying etiology (C1- inhibitor deficiency vs histaminergic) was not known. Results: There were no intraoperative complications, and the patient was discharged home 3 days after the procedure. Conclusions: Optimization of perioperative outcomes in patients, especially during urgent or emergent surgery, with a history of angioedema requires the development of a patient-specific perioperative plan, including prophylaxis, rescue therapies and opioid-sparing strategies. |
url |
https://doi.org/10.1177/2050313X17713912 |
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