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Aphagia Strongly Suspected to Be Caused by an Allergic Reaction to a Gelatin-based Hemostatic Agent after Anterior Cervical Decompression and Fusion for Central Cervical Cord Injury

Gelatin-based hemostatic agents are widely used in neurosurgery. This is a case of postoperative aphagia strongly suspected to be caused by an allergic reaction to a gelatin-based hemostatic agent after anterior cervical decompression and fusion for central cervical cord injury. A 55-year-old man un...

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Autores principales: TANAKA, Satoshi, TOMIO, Ryosuke, AKAO, Norihiko, SHIMIZU, Tsunemasa, ISHIKAWA, Toshio, FUJIMOTO, Takeshi, NISHIMATSU, Terumasa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japan Neurosurgical Society 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9256016/
https://www.ncbi.nlm.nih.gov/pubmed/35855283
http://dx.doi.org/10.2176/jns-nmc.2022-0017
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author TANAKA, Satoshi
TOMIO, Ryosuke
AKAO, Norihiko
SHIMIZU, Tsunemasa
ISHIKAWA, Toshio
FUJIMOTO, Takeshi
NISHIMATSU, Terumasa
author_facet TANAKA, Satoshi
TOMIO, Ryosuke
AKAO, Norihiko
SHIMIZU, Tsunemasa
ISHIKAWA, Toshio
FUJIMOTO, Takeshi
NISHIMATSU, Terumasa
author_sort TANAKA, Satoshi
collection PubMed
description Gelatin-based hemostatic agents are widely used in neurosurgery. This is a case of postoperative aphagia strongly suspected to be caused by an allergic reaction to a gelatin-based hemostatic agent after anterior cervical decompression and fusion for central cervical cord injury. A 55-year-old man underwent cervical anterior decompression and fusion at the C3/4 and 4/5 levels for central cervical cord injury. Immediately after the surgery, he could not swallow saliva at all, but his voice was not hoarse. Postoperative cervical computed tomography and magnetic resonance imaging showed significant edema from the post-hypopharynx wall to the front of the vertebral body. The retropharyngeal space was remarkably enlarged to 15.8 mm with cervical spine X-rays. Without neurological symptom improvement, his condition was diagnosed as marked edema of the area where Surgiflo (porcine-derived gelatin-based hemostatic agent; Johnson & Johnson Wound Management, Somerville, NJ, USA) had been applied during the operation. It was strongly suspected to be caused by an allergic response to the porcine-derived gelatin. When methylprednisolone 1000 mg was administered for 3 days from the 5th postoperative day, swallowing became almost normal within a few hours after the initial administration, and his neurological symptoms improved. The patient left the hospital on the 12th day after the operation. Before using porcine-derived gelatin products during surgery, special consideration should be given to patients with an allergy history before surgery.
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spelling pubmed-92560162022-07-18 Aphagia Strongly Suspected to Be Caused by an Allergic Reaction to a Gelatin-based Hemostatic Agent after Anterior Cervical Decompression and Fusion for Central Cervical Cord Injury TANAKA, Satoshi TOMIO, Ryosuke AKAO, Norihiko SHIMIZU, Tsunemasa ISHIKAWA, Toshio FUJIMOTO, Takeshi NISHIMATSU, Terumasa NMC Case Rep J Case Report Gelatin-based hemostatic agents are widely used in neurosurgery. This is a case of postoperative aphagia strongly suspected to be caused by an allergic reaction to a gelatin-based hemostatic agent after anterior cervical decompression and fusion for central cervical cord injury. A 55-year-old man underwent cervical anterior decompression and fusion at the C3/4 and 4/5 levels for central cervical cord injury. Immediately after the surgery, he could not swallow saliva at all, but his voice was not hoarse. Postoperative cervical computed tomography and magnetic resonance imaging showed significant edema from the post-hypopharynx wall to the front of the vertebral body. The retropharyngeal space was remarkably enlarged to 15.8 mm with cervical spine X-rays. Without neurological symptom improvement, his condition was diagnosed as marked edema of the area where Surgiflo (porcine-derived gelatin-based hemostatic agent; Johnson & Johnson Wound Management, Somerville, NJ, USA) had been applied during the operation. It was strongly suspected to be caused by an allergic response to the porcine-derived gelatin. When methylprednisolone 1000 mg was administered for 3 days from the 5th postoperative day, swallowing became almost normal within a few hours after the initial administration, and his neurological symptoms improved. The patient left the hospital on the 12th day after the operation. Before using porcine-derived gelatin products during surgery, special consideration should be given to patients with an allergy history before surgery. The Japan Neurosurgical Society 2022-06-21 /pmc/articles/PMC9256016/ /pubmed/35855283 http://dx.doi.org/10.2176/jns-nmc.2022-0017 Text en © 2022 The Japan Neurosurgical Society https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives International License.
spellingShingle Case Report
TANAKA, Satoshi
TOMIO, Ryosuke
AKAO, Norihiko
SHIMIZU, Tsunemasa
ISHIKAWA, Toshio
FUJIMOTO, Takeshi
NISHIMATSU, Terumasa
Aphagia Strongly Suspected to Be Caused by an Allergic Reaction to a Gelatin-based Hemostatic Agent after Anterior Cervical Decompression and Fusion for Central Cervical Cord Injury
title Aphagia Strongly Suspected to Be Caused by an Allergic Reaction to a Gelatin-based Hemostatic Agent after Anterior Cervical Decompression and Fusion for Central Cervical Cord Injury
title_full Aphagia Strongly Suspected to Be Caused by an Allergic Reaction to a Gelatin-based Hemostatic Agent after Anterior Cervical Decompression and Fusion for Central Cervical Cord Injury
title_fullStr Aphagia Strongly Suspected to Be Caused by an Allergic Reaction to a Gelatin-based Hemostatic Agent after Anterior Cervical Decompression and Fusion for Central Cervical Cord Injury
title_full_unstemmed Aphagia Strongly Suspected to Be Caused by an Allergic Reaction to a Gelatin-based Hemostatic Agent after Anterior Cervical Decompression and Fusion for Central Cervical Cord Injury
title_short Aphagia Strongly Suspected to Be Caused by an Allergic Reaction to a Gelatin-based Hemostatic Agent after Anterior Cervical Decompression and Fusion for Central Cervical Cord Injury
title_sort aphagia strongly suspected to be caused by an allergic reaction to a gelatin-based hemostatic agent after anterior cervical decompression and fusion for central cervical cord injury
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9256016/
https://www.ncbi.nlm.nih.gov/pubmed/35855283
http://dx.doi.org/10.2176/jns-nmc.2022-0017
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