Anesthesia for Urgent Surgery in a Patient with Angioneurotic Oedema: A Case Report
Said Khallikane, Aziz Benakrout, Hanane Delsa, Mohamed Moutaoukil, Khalil Abou Elalaa, Samir Siah, Hicham Balkhi, Abdelouahed Baite
Journal of Advances in Medicine and Medical Research · pp. 20–26 · Published 19 Oct 2020
10.9734/jammr/2020/v32i1930664Abstract
Hereditary angioneurotic oedema is an autosomal dominant disease associated with serum deficiency of functional C1-inhibitor. It is characterized by periodic swelling of subcutaneous tissues, abdominal viscera and upper airways. Lethal acute episodes of oedema can occur during anaesthesia and surgery. It is essential to prepare such patients before surgery. This article describes a case and the various preventive measures used to avoid acute episodes during anaesthesia for urgent surgery for mesenteric ischemia. In emergency situations where C1 inhibitor concentrate is not available, fresh frozen plasma (FFP) can be used as an alternative, as it also contains C1 inhibitor, corticosteroids, antihistamines, and epinephrine can be useful adjuncts but typically are not efficacious in aborting acute attacks. Prophylactic management involves long-term use of attenuated androgens or antifibrinolytic agents (Tranexamic acid).Their various indications are discussed.
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