Laparoscopic splenectomy in a patient with acquired angioneurotic edema.
BACKGROUND
We report the case of a 77-year-old female with acquired angioneurotic edema, C1 esterase inhibitor level = 4mg/dL, who was scheduled to undergo laparoscopic splenectomy.


METHODS
In the operating room, we administered on call 500 units (UI) of C1 esterase inhibitor concentrate intravenously. Intraoperative hemodynamic instability and generalized blood oozing improved following the administration of aprotinin 250000 UI intravenous (IV) drip.


CONCLUSIONS
We recommend the administration of an antifibrinolytic agent in addition to C1 esterase inhibitor concentrate in patients with acquired angioneurotic edema.
Jabbour-Khoury
S
S
Department of Anesthesiology, American University of Beirut, Lebanon.
Khoury
G
G
Soueide
A
A
Baraka
A
A
D000368:Aged; D000799:Angioedema / Q000150:complications* / Q000517:prevention & control; D007611:Aprotinin / Q000008:administration & dosage; D003174:Complement C1 Inactivator Proteins / Q000008:administration & dosage*; D005260:Female; D006490:Hemostatics / Q000008:administration & dosage; D006801:Humans; D010535:Laparoscopy; D019106:Postoperative Hemorrhage / Q000517:prevention & control; D013156:Splenectomy / Q000379:methods*
D003174:Complement C1 Inactivator Proteins; D006490:Hemostatics; D007611:Aprotinin