術中にアナフィラキシーショックをきたしたラテックスアレルギーの1例  [in Japanese] A Case of Latex Allergy that Resulted in Intraoperative Anaphylactic Shock  [in Japanese]

Access this Article

Search this Article

Author(s)

Abstract

症例は70歳,男性.胃癌(T1b(SM),N0,M0,H0,P0,cStage IA)に対し,腹腔鏡下胃全摘術を施行した.既往に慢性蕁麻疹,バリウムとニフレックによるアナフィラキシーがあった.術前の血清ラテックス抗原特異的IgE抗体は陰性だった.術中,標本摘出と再建のため小開腹を行うと,血圧の急激な低下と顔面紅潮を認めた.ラテックスによるアナフィラキシーショックを疑い,直ちに抗ショック療法と手袋の変更を行い患者の状態は改善した.手術は無事終了し,術後経過は良好だった.術後血清ラテックス抗原特異的IgE抗体は陽性となった.本病態の発症を未然に予想することは非常に困難であり,発症した際には本疾患を鑑別に挙げ,適切な対応をすることで,生命にかかわる事態は避けられると考えられた.

A 70-year-old man underwent laparoscopic total gastrectomy for gastric cancer (T1b(SM), N0, M0, H0, P0, cStage IA). He had a previous history of chronic urticaria and anaphylaxis due to barium and Niflec. Preoperatively, the patient was negative for serum latex antigen-specific immunoglobulin E (IgE) antibody. Intraoperatively, when minilaparotomy was performed for sample resection and reconstruction, he showed a rapid decrease in blood pressure and facial flush. Anaphylactic shock due to latex was suspected, and anti-shock therapy and switching of gloves were immediately performed, after which the patient's condition improved. The surgery was completed uneventfully, and his postoperative course was favorable. Postoperatively, the patient was positive for serum latex antigen-specific IgE antibody. It is extremely difficult to predict the onset of this condition in advance, but in cases in which it does occur, it is considered possible to prevent life-threatening situations through recognition of the disease and appropriate management.

Journal

  • Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)

    Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 75(4), 1124-1128, 2014

    Japan Surgical Association

Codes

  • NII Article ID (NAID)
    130004713919
  • Text Lang
    JPN
  • ISSN
    1345-2843
  • Data Source
    J-STAGE 
Page Top