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Case Reports
. 2017 Jun 8:5:2050313X17713912.
doi: 10.1177/2050313X17713912. eCollection 2017.

Angioedema: Perioperative management

Andrew A Maynard  1 , Christina F Burger  2 , Joseph J Schlesinger  1
Affiliations
Case Reports

Angioedema: Perioperative management

Andrew A Maynard et al. SAGE Open Med Case Rep. .

Abstract

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.

Keywords: C1-inhibitor; Perioperative; acquired angioedema; airway; anesthesiology; angioedema; hereditary angioedema; laryngeal edema; mast cell.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

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