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Intraoperative Anaphylaxis Following Injection of a Bleomycin-Gelatin Solution for Sclerotherapy

During the perioperative period, the most commonly identified agents that are responsible for acute allergic reactions include antibiotics, neuromuscular blocking agents, opioids, chlorhexidine, and iodinated dyes for radiologic imaging. However, whenever an allergic reaction is suspected, all of th...

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Autores principales: Roberts, Laura, Braswell, Leah, Maves, Gregory, Stumpf, Kimberly, Redmond, Margaret, Tobias, Joseph D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elmer Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8993446/
https://www.ncbi.nlm.nih.gov/pubmed/35464330
http://dx.doi.org/10.14740/jmc3906
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author Roberts, Laura
Braswell, Leah
Maves, Gregory
Stumpf, Kimberly
Redmond, Margaret
Tobias, Joseph D.
author_facet Roberts, Laura
Braswell, Leah
Maves, Gregory
Stumpf, Kimberly
Redmond, Margaret
Tobias, Joseph D.
author_sort Roberts, Laura
collection PubMed
description During the perioperative period, the most commonly identified agents that are responsible for acute allergic reactions include antibiotics, neuromuscular blocking agents, opioids, chlorhexidine, and iodinated dyes for radiologic imaging. However, whenever an allergic reaction is suspected, all of the agents to which the patient has been exposed must be considered. Although bleomycin is utilized as the primary agent for sclerotherapy in the treatment of vascular malformations, other substances such as Surgiflo(®) may be added to the bleomycin solution to increase its efficacy and promote thrombosis of the smaller vessels. These products are derived from animal collagen and contain gelatin which may lead to an allergic reaction. We present an 11-year-old girl undergoing sclerotherapy treatment of an extensive left lower extremity venous malformation who subsequently developed perioperative hemodynamic instability requiring intervention after receiving an injection of a bleomycin and Surgiflo(®) solution. Further investigation identified gelatin in the Surgiflo(®) as the causative agent of the allergic event. Previous reports of such reactions are reviewed and the perioperative care and treatment of patients who experience anaphylaxis is addressed.
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spelling pubmed-89934462022-04-22 Intraoperative Anaphylaxis Following Injection of a Bleomycin-Gelatin Solution for Sclerotherapy Roberts, Laura Braswell, Leah Maves, Gregory Stumpf, Kimberly Redmond, Margaret Tobias, Joseph D. J Med Cases Case Report During the perioperative period, the most commonly identified agents that are responsible for acute allergic reactions include antibiotics, neuromuscular blocking agents, opioids, chlorhexidine, and iodinated dyes for radiologic imaging. However, whenever an allergic reaction is suspected, all of the agents to which the patient has been exposed must be considered. Although bleomycin is utilized as the primary agent for sclerotherapy in the treatment of vascular malformations, other substances such as Surgiflo(®) may be added to the bleomycin solution to increase its efficacy and promote thrombosis of the smaller vessels. These products are derived from animal collagen and contain gelatin which may lead to an allergic reaction. We present an 11-year-old girl undergoing sclerotherapy treatment of an extensive left lower extremity venous malformation who subsequently developed perioperative hemodynamic instability requiring intervention after receiving an injection of a bleomycin and Surgiflo(®) solution. Further investigation identified gelatin in the Surgiflo(®) as the causative agent of the allergic event. Previous reports of such reactions are reviewed and the perioperative care and treatment of patients who experience anaphylaxis is addressed. Elmer Press 2022-04 2022-03-25 /pmc/articles/PMC8993446/ /pubmed/35464330 http://dx.doi.org/10.14740/jmc3906 Text en Copyright 2022, Roberts et al. https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution Non-Commercial 4.0 International License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Roberts, Laura
Braswell, Leah
Maves, Gregory
Stumpf, Kimberly
Redmond, Margaret
Tobias, Joseph D.
Intraoperative Anaphylaxis Following Injection of a Bleomycin-Gelatin Solution for Sclerotherapy
title Intraoperative Anaphylaxis Following Injection of a Bleomycin-Gelatin Solution for Sclerotherapy
title_full Intraoperative Anaphylaxis Following Injection of a Bleomycin-Gelatin Solution for Sclerotherapy
title_fullStr Intraoperative Anaphylaxis Following Injection of a Bleomycin-Gelatin Solution for Sclerotherapy
title_full_unstemmed Intraoperative Anaphylaxis Following Injection of a Bleomycin-Gelatin Solution for Sclerotherapy
title_short Intraoperative Anaphylaxis Following Injection of a Bleomycin-Gelatin Solution for Sclerotherapy
title_sort intraoperative anaphylaxis following injection of a bleomycin-gelatin solution for sclerotherapy
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8993446/
https://www.ncbi.nlm.nih.gov/pubmed/35464330
http://dx.doi.org/10.14740/jmc3906
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