Can’t Intubate, Can’t Oxygenate: A Rare Case of a Difficult Airway due to Nonhereditary Angioedema
Angioedema is a form of allergic mediated by histamine and non-allergic mediated by bradykinin and can be lethal if not recognized and treated promptly. This case demonstrates the proper diagnosis of and intervention in rapid onset severe angioedema. A 68-year-old male came to the emergency depar...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Sestre Milosrdnice University hospital, Institute of Clinical Medical Research
2022-01-01
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| Series: | Acta Clinica Croatica |
| Subjects: | |
| Online Access: | https://hrcak.srce.hr/file/407863 |
| Summary: | Angioedema is a form of allergic mediated by histamine and non-allergic mediated
by bradykinin and can be lethal if not recognized and treated promptly. This case demonstrates
the proper diagnosis of and intervention in rapid onset severe angioedema.
A 68-year-old male came to the emergency department with a complaint of dyspnea that started
two hours before. He had type II diabetes, chronic kidney disease and several different antihypertensive
medications, including an ACE inhibitor for hypertension. During physical examination, the
patient was hypertensive, tachycardic, tachypnoic, and edematous. During his stay in the ED he was
treated with a combination of corticosteroids, antihistamines and epinephrine, but the patient’s edema
and dyspnea worsened and his oxygen saturation started to deteriorate with a progression of skin
edema. Intubation was not possible due to the large edema of the tongue, so a tracheotomy was done.
An ampule of icatibant was administered and rapid regression of the edema, along with the stabilization
of the patient’s vital signs, followed after five minutes. The patient was discharged home after five
days with a recommendation of discontinuing the ACE inhibitor.
While non-hereditary |
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| ISSN: | 0353-9466 1333-9451 |