Case 40: Acute Abdomen

  • John G. Brock-Utne
Chapter

Abstract

A 13-year-old girl (120 lbs) presents with acute colicky abdominal pain and is scheduled for an emergency appendectomy. Her history is unremarkable. The mother informs you that the onset of the pain may be related to the patient having her first menses. Neither the patient nor the immediate family has had a general anesthetic. The mother informs you that she believes that the girl’s father’s family has an “upset metabolism.” She knows nothing more about this abnormality except to say that she is sure it has nothing to do with succinylcholine. The father is unavailable for comment. The patient is taking no medication and is classified as an American Society of Anesthesiologists physical status II (ASA 2). The patient complains of severe abdominal pain and is very nauseous. You examine the patient and nothing abnormal is detected. The abdominal wall is lax. Some rebound tenderness is noted in the right iliac fossa, but much less than would be expected from acute appendicitis. No blood analysis or urinalysis is done. The surgeon is anxious to proceed.

Keywords

Morphine Neuropathy Ketamine Appendicitis Barbiturate 

References

  1. 1.
    Parr MJA, Hayden-Smith J. Propofol, porphyria and epilepsy. Anaesthesia. 1990;45:594.PubMedCrossRefGoogle Scholar
  2. 2.
    Mitterschiffthaler G, Theiner A, Hetzel H, Fuith LC. Safe use of propofol in a patient with acute intermittent porphyria. Anaesthesia. 1988;60:109–11.CrossRefGoogle Scholar
  3. 3.
    Cooper R. Anaesthesia for porphyria using propofol. Anaesthesia. 1988;43:611.PubMedCrossRefGoogle Scholar
  4. 4.
    McLoughlin C. Use of propofol in a patient with porphyria. Anaesthesia. 1989;62:114.Google Scholar
  5. 5.
    Haberer JP, Malthe R. Propofol in acute porphyria. Anaesthesia. 1989;44:932.CrossRefGoogle Scholar
  6. 6.
    Rizk SF, Jacobsen JH, Silvay G. Ketamine as an induction agent for acute intermittent porphyria. Anesthesiology. 1977;46:305–6.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • John G. Brock-Utne
    • 1
  1. 1.Department of AnesthesiaStanford UniversityStanfordUSA

Personalised recommendations