Anaphylactic and Hemorrhagic Shock during Disseminated Abdominal Hydatidosis Surgery: A Case Report

Hydatidosis is a frequent pathology which remains endemic in Morocco. Its preferred location is the liver while the peritoneal location remains rare, even more rarely the pelvic location. The treatment is mainly surgical, but this surgery can be complicated (intraoperatively) by potentially serious accidents, it can be implicated in the occurrence of severe allergic reactions which can be life-threatening, more rarely by hemorrhagic accidents, especially if the cysts keep important and close vascular contact. We report the observation of a case of disseminated peritoneal hydatidosis supra-mesocolic, sub-mesocolic, pelvic and hepatic surgery complicated first by anaphylactic shock and secondarily by hemorrhagic shock. We insist on the need for its rapid recognition in order to quickly institute an adequate and effective treatment. The prevention of this accident is based on surgical precautions to prevent leaks or accidental intraoperative ruptures of hydatid cysts.

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Extrapulmonary Intrapleural Hydatid Disease- A Case Report

MedPharmRes ◽

10.32895/ump.mpr.3.1.12 ◽

2019 ◽

Vol 3 (1) ◽

pp. 12-16

Author(s):

Muhammad Usman Hashmi ◽

Muhammad Kaleem Ullah ◽

Mohsin Sarwar ◽

Alia Sultan ◽

Abdul Aleem ◽

...

Keyword(s):

Case Report ◽

Hydatid Disease ◽

Critical Role ◽

Lung Parenchyma ◽

Pleural Space ◽

Pressure Effects ◽

Uneventful Recovery ◽

Hydatid Cysts ◽

Life Threatening ◽

Missed Diagnosis

Hydatidosis is a zoonotic disease caused by the tapeworm Echinococcus granulosus. It mostly involves liver and lungs whereas the unusual sites are spleen, kidney, peritoneal cavity, skin, muscles, heart, brain, vertebral column, ovaries, pancreas, gallbladder, thyroid gland, breast, and bones. Herein, we describe a unique case of intrapleural hydatid cyst which was solely confined to the pleural space without involvement of lung parenchyma and other associated structures. Despite the fact that Pakistan is an endemic country for hydatid disease, we could not identify any single documented case of intrapleural hydatid disease from Pakistan. The purpose of our case report is to promote awareness among fellow healthcare professionals about this rare variant of hydatid disease and to prevent any missed diagnosis and life-threatening complications. Hence, once the diagnosis was established, we performed a right-sided thoracotomy. Intraoperatively, the lung was collapsed due to the pressure effects of hydatid cysts. The hydatid cysts were evacuated completely from the pleural cavity and postoperatively the patient had an uneventful recovery and remained asymptomatic during all the follow-up visits. Conclusively, the hydatid disease may involve unusual sites such as the pleural space. A strong clinical suspicion, supportive radiological findings, and positive serological evidence play a critical role in the establishment of the diagnosis.

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The usefulness of the virtual patient program in the nursing care of patients with anaphylactic shock – case report

Progress in Health Sciences ◽

10.5604/01.3001.0012.1333 ◽

2018 ◽

Vol 8 (1) ◽

pp. 219-224

Author(s):

P. Więch ◽

P. Rozborska ◽

D. Bazaliński ◽

I. Sałacińska ◽

P. Januszewicz

Keyword(s):

Case Report ◽

Nursing Care ◽

Anaphylactic Shock ◽

Virtual Patient ◽

Real Situation ◽

Risk Of Death ◽

Threatening Condition ◽

Life Threatening ◽

Progressive Course

Anaphylactic shock is a life-threatening condition characterized by a severe and rapid course causing disorders in the digestive, cardiovascular and respiratory systems. The paper presents a virtual patient program. It allows to analyze each phase of the shock safely, which is often impossible in the real situation due to the fast and progressive course. Right actions and proper patterns of care by nursing staff will help to reduce the risk of death and increase the quality of care.

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Aortic Dissection with Rare Anatomical Aortic Arch Variation Depicted by Computed Tomography Angiography

The Heart Surgery Forum ◽

10.1532/hsf.3619 ◽

2021 ◽

Vol 24 (2) ◽

pp. E407-E408

Author(s):

Xin Wang ◽

Bofu Liu ◽

Haifang Yu

Keyword(s):

Computed Tomography ◽

Case Report ◽

Aortic Dissection ◽

Effective Treatment ◽

Aortic Arch ◽

Endovascular Repair ◽

Computed Tomography Angiography ◽

Chest Trauma ◽

Life Threatening ◽

Treatment Surgery

Aortic dissection (AD) is a life-threatening disease, and endovascular repair by stent graft is an effective treatment. Surgery often fails for a variety of reasons, such as aortic arch variation. We present the case of a 27-year-old female with aortic dissection with a rare anatomical aortic arch variation caused by chest trauma. This patient recovered well after endovascular repair. This case report demonstrates endovascular repair can be applied to aortic dissection patients with rare anatomical aortic arch variation.

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Amphotericin B Induced Anaphylactic Reaction and Electrolyte Imbalance: A Case Report

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i59b34440 ◽

2021 ◽

pp. 735-739

Author(s):

Sheik Haja Sherief ◽

Shilpa Johny Chackupurackal ◽

S. Sengottuvelu ◽

Mercy Dora ◽

V. Manivannan ◽

...

Keyword(s):

Case Report ◽

Fungal Infection ◽

Amphotericin B ◽

Anaphylactic Reaction ◽

Cardiac Toxicity ◽

Electrolyte Imbalance ◽

Allergic Reactions ◽

Chest Discomfort ◽

Life Threatening ◽

Streptomyces Nodosus

Amphotericin B, a polyene antifungal antibiotic derived from a strain of Streptomyces nodosus. It acts by binding to sterols in the cell membrane of susceptible fungi, with a resultant change in the permeability of the membrane. Amphotericin B can cause allergic reactions, electrolyte imbalance and severe side effects, such as chest discomfort accompanied by dyspnea, flushing, agitation, tachypnea, tachycardia, hypoxemia, hypotension, or hypertension, are likely to develop following the injection of Amphotericin B. Anaphylaxis, cardiac toxicity and respiratory failure have also been associated to different formulations of Amphotericin B as life-threatening acute events. This case report is on a 57-year-old male patient who was admitted with a condition of left diabetic foot with non-healing medial supra heel ulcer and fungal infection on the site of wound. The patient was given Amphotericin B in emulsion form due to the high priority of fungal infection and the need for antifungal medicine, which led to anaphylactic reaction and electrolyte imbalance, which were treated immediately and the same preparation was continued with a low infusion rate. When infusion is discontinued, antihistamines can assist to alleviate the symptoms. In this case, it is recommended that the patient's condition and clinical parameters should be closely followed after the medicine has been administered.

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Successful Drug Desensitization to Ustekinumab in a Patient with Crohn’s Disease

Case Reports in Gastroenterology ◽

10.1159/000516318 ◽

2021 ◽

pp. 657-661

Author(s):

Barrie Cohen ◽

Gitit Tomer ◽

Tatyana Gavrilova

Keyword(s):

Monoclonal Antibody ◽

Crohn’S Disease ◽

Case Report ◽

Crohn's Disease ◽

Multidisciplinary Approach ◽

Allergic Reactions ◽

Treatment Needs ◽

Inflammatory Conditions ◽

Life Threatening ◽

Desensitization Protocol

Ustekinumab is a monoclonal antibody used as treatment for various inflammatory conditions. We present a pediatric patient with Crohn’s disease who did not tolerate infliximab and was then changed to ustekinumab. He developed anaphylaxis to the medication after the second dose. A drug desensitization protocol was created by the allergy team leading to successful administration of both intravenous and then subcutaneous ustekinumab. As monoclonal agents become mainstays of therapy for inflammatory conditions, there are increased reports of allergic reactions. Prior reports and protocols of ustekinumab desensitization have not been reported. This case report highlights successful desensitization to ustekinumab as well as the importance of a multidisciplinary approach to addressing treatment needs of patients who develop life-threatening reactions to such medications.

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Severe injury to the brachial neurovascular bundle and muscles due to a horse bite: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-021-02863-w ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Hajriz Rudari ◽

Luan Jaha ◽

Adhurim Koshi ◽

Lulzim Vokrri

Keyword(s):

Case Report ◽

Hemorrhagic Shock ◽

Brachial Artery ◽

Fresh Frozen Plasma ◽

Basilic Vein ◽

Before And After ◽

Fresh Frozen ◽

Life Threatening ◽

Time Of Admission ◽

Patient Emergency

Abstract Introduction Only a small portion of horse injuries are related to horse bites. In the majority of these occurrences, injuries are minor and self-treated. However, in some cases, the injury may be destructive and limb- and life-threatening. In these instances, the patient requires complex surgery and compound perioperative care. Case report We present the case of a 35-year-old Albanian male farm-worker in whom a horse bite caused an extensive lacero-contusive and avulsive wound to the arm. The wound resulted in injury to the brachial artery, brachial and basilic vein, and biceps and brachialis muscles. Nerve structures and underlying humerus remained intact. The initial management of the severe hemorrhagic shock caused by the bleeding at the site of injury included reconstruction of the brachial artery by interposing saphenous graft and that of the brachial vein by termino-terminal anastomosis. Basilic vein was ligated. The wound was extensively debrided, and after a drain was placed in the wound, biceps and brachialis muscles were reconstructed. The patient received several units of red blood cells and fresh frozen plasma before and after surgery, as well as antibiotic, antitetanic, and antirabies prophylaxes. He had several consecutive necrectomies in the following days. However, due to postoperative sepsis and hemorrhagic shock at time of admission, the patient developed acute renal failure, therefore requiring several hemodialysis sessions. After his general and local condition was stabilized, the patient also underwent several reconstructive surgeries. Conclusion Horse bites of large extent require a multidisciplinary approach. The composition of the team of physicians needed for treatment varies depending on the degree of the injury and eventual complications. In the case of our patient, emergency department physicians, vascular and plastic surgeons, intensive care specialists, nephrologists, and infective care specialists were involved. In different instances, the inclusion of other specialists may be necessary to save and functionalize the limbs of the patient, or save his/her life.

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Life-threatening rocuronium-induced anaphylactic shock without cutaneous manifestations successfully reversed with sugammadex: a case report

JA Clinical Reports ◽

10.1186/s40981-020-00402-y ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Yoshiaki Takise ◽

Jungo Kato ◽

Tomohiro Suhara ◽

Takashige Yamada ◽

Takeru Funakoshi ◽

...

Keyword(s):

Case Report ◽

Anaphylactic Shock ◽

Clinical Manifestations ◽

Skin Grafting ◽

Basophil Activation Test ◽

Circulatory Collapse ◽

Cutaneous Manifestations ◽

Thickness Skin ◽

Split Thickness Skin Grafting ◽

Life Threatening

Abstract Background Recognition of rocuronium-induced anaphylaxis is often challenging, owing to its diverse clinical manifestations. Regarding treatment, several reports have described the efficacy of sugammadex, while conflicting reports have also been published. Case A 71-year-old man was scheduled to undergo split-thickness skin grafting surgery on his hip. During the induction of general anesthesia, the patient developed profound circulatory collapse without any cutaneous manifestations, which required 40 min of cardiopulmonary resuscitation. Later, the patient developed circulatory collapse again during the induction of anesthesia for tracheostomy surgery, which apparently coincided with the administration of rocuronium. Rocuronium-induced anaphylactic shock was suspected, and the administration of sugammadex resulted in swift recovery of hemodynamics. The basophil activation test revealed a positive reaction to rocuronium. Conclusion The possibility of rocuronium-induced anaphylaxis should be considered when the circulatory collapse coincides with rocuronium administration, even though cutaneous manifestation is absent. Sugammadex can be a treatment option in such atypical cases.

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One shock after another; simulation can prevent fixation errors: A case report

Anaesthesia, Pain & Intensive Care ◽

10.35975/apic.v23i4.1179 ◽

2020 ◽

Cited By ~ 1

Author(s):

Natacha Husson ◽

Claudia Carreira ◽

Nuno Babo

Keyword(s):

Case Report ◽

Hemorrhagic Shock ◽

Skill Acquisition ◽

Anaphylactic Shock ◽

Life Support ◽

Improve Patient Safety ◽

Advanced Life Support ◽

Exploratory Laparotomy ◽

Emergency Laparotomy ◽

Abdominal Sonography

Introduction: Safety is essential in all the anesthesiologists’ activity. Anesthesiology pioneered the use of simulation in training. Human factors play a big part in critical incidents. Understanding and identifying key cognitive errors specific to anesthesiology is the first step in metacognition training and strategies to prevent these errors and improve patient safety. A 64y female patient, ASA III, submitted to emergency laparotomy with right hemicolectomy. Surgery went uneventful until wound closure. After metamizole administration, the patient had had generalized skin rash, hypoxemia, bradycardia and hypotension, treated as an anaphylactic shock. In the recovery room, she had another episode of severe She had cardiac arrest. Advanced life support was successful. Ecofast (acronym for “The Focused Abdominal Sonography for Trauma Scan") revealed intraperitoneal fluid compatible with massive hemoperitoneum. Hemorrhagic shock was treated with exploratory laparotomy and hemodynamic support with progressive improvement. It is important to note that a possible fixation error could have delayed the diagnosis of the hemorrhagic shock that overlapped the first anaphylactic shock and culminated in cardio-respiratory arrest. Fixation errors occur when one focuses only on one factor rather than other equally relevant and more predictable ones. Training through simulation increases awareness of potential problems in routine and non-routine settings and allows faster skill acquisition and recognition of problems. ACRM programs where the CRM model is applied to anesthesiology, allows the teaching and training of team behaviors in crisis situations. Citation: Husson N, Carreira C, Babo N. One shock after another; simulation can prevent fixation errors: A case report. Anaesth pain & intensive care 2019;23(4)__

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