KİST HİDATİK CERRAHİSİNDE DİRENÇLİ ANAFİLAKTİK ŞOK GELİŞEN OLGUNUN YÖNETİMİ

Abstract

Kist hidatik rüptürü, anafilaktik şok hatta ölüme kadar ilerleyebilen, alerjik reaksiyonlara neden olabilir. Bu makalede, laparoskopik kist hidatik cerrahisine alınan kardiyak peysli hastada gelişen dirençli anafilaktik şok tablosunun yönetimi sunulmuştur. Laparoskopik cerrahi uygulanan bu olguda, ilk tablonun ani hipotansiyon ile ortaya çıkması, cilt döküntülerinin ve solunumsal belirtilerin geç görülmesi ayırıcı tanıyı zorlaştırmıştır. AV tam bloğa bağlı kardiyak peys varlığı, ST segment analizi ve taşi-bradikardi durumlarını değerlendirmemizi engellemiştir. Sonuç olarak, kist hidatik cerrahi sırasında belirgin makroskopik rüptür olmaksızın anafilaksi gelişebilir ve refrakter anafilaktik şoka yola açabilir. Komorbid hastalığı olan kardiyak hastalarda anafilaktik şokun tanınması ve yönetimi güç olabilir. Anafilaktik şokun erken tanınması ve tedavisinde erken intramusküler adrenalin uygulanması gerektiği unutulmamalıdır.

Keywords

• Anafilaksi
• Anafilaktik Şok
• Kist Hidatik
• Resüsitasyon

MANAGEMENT OF A CASE DEVELOPING RESISTANT ANAPHYLACTIC SHOCK IN HYDATID CYST SURGERY

Abstract

Hydatid cyst rupture can cause allergic reactions that can progress to anaphylactic shock or even death. This article presents the management of resistant anaphylactic shock in a patient with cardiac pacing who underwent laparoscopic hydatid surgery. In this case, who underwent laparoscopic surgery, the initial presentation with sudden hypotension and the late appearance of skin rashes and respiratory symptoms made the differential diagnosis difficult. The presence of cardiac pace due to complete AV block prevented us from evaluating ST segment analysis and tachy-bradycardia. In conclusion, anaphylaxis may develop and can cause refractory anaphylactic shock without significant macroscopic rupture findings during hydatid surgery. Recognition and management of anaphylactic shock can be difficult in cardiac patients with comorbid diseases. It should not be forgotten that early intramuscular adrenaline should be administered in the early recognition and treatment of anaphylactic shock.

Keywords

• Anaphylaxis
• Anaphylactic Shock
• Hydatid Cyst
• Resuscitation

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