Abstract

FERRARI ACOSTA, María Gabriela  and  AMOROSO COSIMINI, Leonel Ezequiel. Evaluación perioperatoria de una paciente con un angioedema grave para una cirugía de coordinación. Anest Analg Reanim [online]. 2013, vol.26, n.1, pp.8-8. ISSN 1688-1273.

SUMMARY  Introduction: angioedema is a disease characterized by recurrent, self-limited episodes of subcutaneous or submucosal edema, that may seriously affect the airway during different stages of the surgery. The diagnosis of its etiology is essential for treatment and prevention. Objectives: to present the preoperative evaluation of a patient diagnosed with angioedema who will be subject to a scheduled surgery, with a focus on the etiologic assessment and the preoperative period. Clinical case: female patient, 32 years of age, with scheduled surgery for cholecystectomy with radiological exploration of main biliary tract, diagnosed with angioedema in 2009, characterized by recurrent episodes of edema in extremities, face, lips, tongue and uvula, associated to respiratory distress, abdominal symptoms; she consulted in several occasions, and was treated with corticosteroids, antihistamines and adrenaline by inhalation, with good response. There is no family history of angioedema. Autoimmune diseases were discarded (lupus and rheumatoid arthritis). Fibrogastroscopy with negative biopsy for Helicobacter pylori. Prick tests positive for mite, dust and different types food. Discussion: C4 and C1 inhibitor were normal, therefore, hereditary and acquired C1 inhibitor deficiency was discarded in the first place, as well as autoimmune diseases and Helicobacter pylori infection. Pharmacological causes were discarded. Due to the atopic field and positive prick tests, the diagnosis presented was allergic or pseudoallergic angioedema. Planned preoperative prophylaxis: antihistamines 5 to 7 days and corticosteroids 2 to 3 days, orally. Conclusions: we present a clinical case with very low frequency where the use of a diagnostic algorithm is fundamental for the prophylaxis of severe anesthetic complications.

Keywords : ANGIOEDEMA; HEREDITARY ANGIOEDEMA; ACQUIRED ANGIOEDEMA; ALLERGIC ANGIOEDEMA; PERIOPERATORY.

        · abstract in Spanish | Portuguese     · text in Spanish     · Spanish ( pdf )