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International Journal of Advances In Case Reports

Volume 11, Issue 1, 2024
Mcmed International
International Journal of Advances In Case Reports
Issn
XXX-XXXX (Print), 2349 - 8005 (Online)
Frequency
bi-annual
Email
editorijacr@mcmed.us
Journal Home page
http://mcmed.us/about/ijacr
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Abstract
Title
MENDELSON SYNDROME IN PATIENT POSTED FOR LAPAROSCOPIC CHOLECYSTETOMY
Author
Sandhya Gujar*, Gayatri Swamy, Manisha Sonwane, Kruti Mehta
Email
drsandhyagujar@gmail.com
keyword
Aspiration of gastric contents, Mendelson Syndrome
Abstract
Mendelson syndrome is characterized by bronchopulmonary reaction following aspiration of gastric contents during general anaesthesia due to abolition of the laryngeal reflexes. The main clinical features are signs of general hypoxia, rales, rhonchi, and tachycardia with a low blood pressure. Decreased arterial oxygen tension is present. Pulmonary edema can cause sudden death. Here we are presenting with a case report of 52 year old male posted for laparoscopic cholecystectomy for empyema of gall bladder Following intubation yellow colored gastric secretions were seen coming from endotracheal tube. On auscultation of chest there were crepitation and wheeze. Respiratory monitor showed increased peak pressure. Patient was manually ventilated using Bain circuit. After creation of Pneumoperitoneum patient’s peak pressures increased further up to 60cm of H2O and ETCO2 increased up to 70mm of Hg, therefore it was decided to do open cholecystectomy to prevent further CO2 insufflation. Patient started showing signs of pulmonary edema with pink frothy secretions from endotracheal tube. Patient was managed with intravenous diuretics, steroids, antacids, prokinetics, bronchodilators, nebulisation with steroids and bronchodilators through endotracheal tube. ABG showed severe acidosis with hypoxemia and hypercarbia. Because of empyema of gall bladder patient had increased gastric secretions and unexpectedly developed acid aspiration. With the help of respiratory monitors it was immediately diagnosed and treated accordingly. Thus patient with acid aspiration and pulmonary edema can be managed successfully with prompt diagnosis and treatment.
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