The efficacy of prophylaxis for anaphylaxis in cyst hydatid surgery

Hydatic cyst is caused by a parasite called Echinococcus granulosus which found in agriculture and animal husbandry and environmental health and preventive medicine measures are inadequate in all societies. People mainly get the disease by dogs which have illness and with the consumption of contaminated vegetables and water. 14 year old female patient, preoperative physical examination and laboratory findings were normal. Abdominal ultrasonography was compatible with the view of hydatic cysts. For prophylaxy of anaphylaxis, intravenous methylprednisolone and pheniramine maleate were performed. While placing 6F catheter into the cyst cavity by using modified Seldinger method, sudden hypotension and arrhythmia were observed. Intravenously adrenaline and atropine were administered. Colloid and crystalloid infusion was started quickly. Decrease in systolic blood pressure up to 35mmHg anaphylactic reaction was thought. Soon bronchospasm developed and SpO2 dropped to 72%. Spontaneous respiration started 30 minutes after the induction and blood pressure was measured 70/50 mmHg, SpO2:92%. After the completion of the radiological intervention patient was taken to intensive care unit with intubated. After 8 hours, the onset of anaphylaxis symptoms, the patient was extubated.. 24 hours after the surgery patient was sent to ward of pediatric surgery. As a result, for the hydatid cysts invasive procedures although prophylaxis for the anaphylaxis has been given, anaphylaxis still occurred. But the prophylaxis may reduce the mortality and make the anaphylaxis milder.