Uro-5. Intraoperative anaphylaxis secondary to latex allergies.

Latex allergies have become increasingly common and represent a potentially fatal intraoperative complication. We report on two patients who experienced intraoperative anaphylaxis secondary to previously undiagnosed latex allergies. A 5-year-old male with a horseshoe kidney had an atrophic right renal moiety resulting in hypertension. He presented for a right heminephrectomy. He had undergone multiple previous operations in the past without incident and had no previous allergies. A midline approach was utilized, and once the bowels were manipulated by the surgeons' hands, the patient developed an anaphylactic response. He was treated with epinephrine, corticosteroids, and H1 and H2 blockers, and his condition stabilized. His operation was aborted and he had an uneventful recovery. Latex specific RAST was diagnostic for latex allergy. A second patient was a 31-year-old female with a vesicovaginal fistula. She also had undergone multiple previous operations, but had never experienced any adverse reactions to any drugs or substances. Upon exploration, she suddenly became unstable with severe hypotension and bronchospasm. She was treated with epinephrine, corticosteroids, and H1 and H2 blockers, and her condition stabilized. Her operation was aborted and her recovery was uneventful as well. Her latex specific RAST was also diagnostic for latex allergy. With the incidence of latex allergy on the rise, it has become necessary for all health care workers to be aware of its manifestations. Equally important is the awareness of the populations at risk for latex allergy such as patients with spina bifida, atopic disease, health care workers, and patients who have undergone multiple operations. Only with prevention and prompt treatment will we be able to avoid this potentially deadly condition.

David Owens, Howard Woo, Joseph Ortenberg, and J. Christian Winters. Ochsner Clinic, New Orleans, LA.