Rectal stump lavage: simple procedure resulting in life-threatening complication

Asian J Surg. 2007 Jan;30(1):72-4. doi: 10.1016/S1015-9584(09)60132-9.

Abstract

In colorectal resections, rectal stump lavage is commonly performed prior to primary anastomosis for reducing bacterial counts and minimizing the risk of anastomotic recurrence. Being a potent bactericidal and cytotoxic disinfectant, chlorhexidine is frequently chosen as the irrigation solution of choice for such purposes. Despite its widespread use, the potential for developing chlorhexidine allergy is still a major concern due to the ever-rising number of literature reports of hypersensitivity reactions to chlorhexidine in surgical patients. This report illustrates the first reported case of life-threatening chlorhexidine anaphylaxis after its use in rectal stump lavage for colorectal resection. This report serves as a reminder of the potential danger of this "hidden allergen" in clinical practice.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anaphylaxis / chemically induced*
  • Anastomosis, Surgical
  • Anti-Infective Agents, Local / adverse effects*
  • Chlorhexidine / adverse effects*
  • Digestive System Surgical Procedures
  • Humans
  • Intraoperative Complications*
  • Male
  • Rectal Neoplasms / surgery
  • Rectum / surgery*
  • Therapeutic Irrigation / adverse effects*

Substances

  • Anti-Infective Agents, Local
  • Chlorhexidine