Demographic and Clinical Characteristics of Patients with Anaphylactic Shock after Surgery for Cystic Echinococcosis

Yimei Li Department of Anesthesiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, People's Republic of China

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Hong Zheng Department of Anesthesiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, People's Republic of China

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Xinghua Cao Department of Anesthesiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, People's Republic of China

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Zaoling Liu Department of Anesthesiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, People's Republic of China

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Lili Chen Department of Anesthesiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, People's Republic of China

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We reviewed the records of 446 patients who were treated surgically for cystic echinococcosis (CE) to identify risk factors for anaphylactic shock. Of 446 patients, 10 had final diagnoses of anaphylactic shock induced by CE; none died. The incidence of anaphylactic shock was significantly higher in younger age groups (P < 0.001) and in patients with pulmonary cysts. Anaphylactic shock induced by CE appears to differ from type I immediate hypersensitivity shock, which suggests that in CE, shock may be caused by a combination of immediate hypersensitivity and endotoxic shock. This possibility suggests that additional precautions should be taken during surgery. These precautions include reducing intracystic pressure, which would prevent possible leaked liquid from reaching other organs by surrounding the cyst with sterile gauze and decrease the chance of spreading the echinococcus; preventing antigen from contacting other tissues where it might trigger anaphylaxis; and resecting the cyst completely when feasible.

Author Notes

*Address correspondence to Hong Zheng, Department of Anesthesiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, People's Republic of China. E-mail: hanlihanyun@sina.com

Financial support: This study was supported by National Natural Science Foundation of China (no. 30960367, 2009) and the Natural Science Foundation of Xinjiang Uighur Autonomous Region (no. 200821141, 2008).

Authors' addresses: Yimei Li, Hong Zheng, Xinghua Cao, Zaoling Liu, and Lili Chen, Department of Anesthesiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, People's Republic of China, E-mails: hanyuner1969@163.com, hanlihanyun@sina.com or xyzhenghong@yahoo.com.cn, drcaoxinghua@yahoo.com.cn, zaolingliu@gmail.com, and 25549898@163.com.

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