[Intraoperative anaphylaxis in a patient with undiagnosed latex sensitivity].
Latex allergy is a cause of anaphylactic reactions during general anesthesia. It is currently the second most common cause of anaphylaxis during anesthesia and should be considered in all cases in which signs develop during surgery. Clinical manifestations are highly variable and depend on the type and amount of exposure to the allergen as well as on individual sensitivity. Cardiovascular collapse is the most common presentation in anesthetized patients, and the second most common manifestations are skin rash and bronchospasm. Latex gloves are implicated in most allergic reactions triggered by latex. Individuals allergic to latex are also sensitive to certain fruits (latex-fruit syndrome) because the presence of specific proteins common in both causes a phenomenon known as cross reactivity. A 34-year-old man with acute abdomen underwent emergency exploratory laparoscopy, which was converted to laparotomy based on findings in the surgical field. Coinciding with surgical manipulation, the patient developed severe hypotension, tachycardia, bronchospasm, and arterial desaturation, which responded favorably to intravenous fluids and medication. After all other possible causes of the events were ruled out, intraoperative anaphylactic reaction was suspected and later confirmed by tests, including allergy tests. When the patient was stable and the surgical environment was latex-free, the procedure was carried out with no complications and the postoperative course was uneventful.
Sánchez-Ródenas
L
L
Servicio de Anestesiología y Reanimación, Hospital Universitario Virgen de la Arrixaca, Murcia. lorenzosaro@hotmail.com
Sánchez-Ortega
J L
JL
D000328:Adult; D000707:Anaphylaxis / Q000209:etiology*; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology*; D020315:Latex Hypersensitivity / Q000150:complications*; D008297:Male