Benzocaine-Induced Methemoglobinemia in a Postoperative Bariatric Patient following Esophagogastroduodenoscopy
Methemoglobinemia is a rare complication in clinical practice. It is most commonly seen in patients undergoing endoscopic procedures, including EGDs, laryngoscopies, bronchoscopies, and nasogastric tube insertions. This is thought to be a disease seen almost exclusively in patients with genetic pred...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Case Reports in Critical Care |
| Online Access: | http://dx.doi.org/10.1155/2019/1571423 |
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| author | Khuram Khan Irwin White-Gittens Saqib Saeed Leaque Ahmed |
| author_facet | Khuram Khan Irwin White-Gittens Saqib Saeed Leaque Ahmed |
| author_sort | Khuram Khan |
| collection | DOAJ |
| description | Methemoglobinemia is a rare complication in clinical practice. It is most commonly seen in patients undergoing endoscopic procedures, including EGDs, laryngoscopies, bronchoscopies, and nasogastric tube insertions. This is thought to be a disease seen almost exclusively in patients with genetic predispositions to develop it; the increasing use of topical anesthetics during procedures has made methemoglobinemia a disease entity that every clinical provider should be able to recognize and treat. Clinically, patients become cyanotic with mild oxygen derangements on pulse oximetry, in the range of 84 to 90%. Paradoxically, these patients demonstrate normal to supranormal oxygen levels in the blood on blood gas analysis. We report a case of 34-year-old female postoperative Roux-en-Y gastric bypass patient who developed hypoxia and cyanosis after a routine EGD procedure to relieve a food impaction. Differentials of aspiration and pulmonary embolism were plausible; stat blood gas analysis clinched the diagnosis and managed with intravenous methylene blue. |
| format | Article |
| id | doaj-art-58e0c4ed6ba34c84a28324169ca4ef9e |
| institution | Kabale University |
| issn | 2090-6420 2090-6439 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Critical Care |
| spelling | doaj-art-58e0c4ed6ba34c84a28324169ca4ef9e2025-02-03T05:57:12ZengWileyCase Reports in Critical Care2090-64202090-64392019-01-01201910.1155/2019/15714231571423Benzocaine-Induced Methemoglobinemia in a Postoperative Bariatric Patient following EsophagogastroduodenoscopyKhuram Khan0Irwin White-Gittens1Saqib Saeed2Leaque Ahmed3Department of Surgery, Harlem Hospital Center, Columbia University Medical Center, New York, NY, USADepartment of Surgery, Harlem Hospital Center, Columbia University Medical Center, New York, NY, USADepartment of Surgery, Harlem Hospital Center, Columbia University Medical Center, New York, NY, USADepartment of Surgery, Harlem Hospital Center, Columbia University Medical Center, New York, NY, USAMethemoglobinemia is a rare complication in clinical practice. It is most commonly seen in patients undergoing endoscopic procedures, including EGDs, laryngoscopies, bronchoscopies, and nasogastric tube insertions. This is thought to be a disease seen almost exclusively in patients with genetic predispositions to develop it; the increasing use of topical anesthetics during procedures has made methemoglobinemia a disease entity that every clinical provider should be able to recognize and treat. Clinically, patients become cyanotic with mild oxygen derangements on pulse oximetry, in the range of 84 to 90%. Paradoxically, these patients demonstrate normal to supranormal oxygen levels in the blood on blood gas analysis. We report a case of 34-year-old female postoperative Roux-en-Y gastric bypass patient who developed hypoxia and cyanosis after a routine EGD procedure to relieve a food impaction. Differentials of aspiration and pulmonary embolism were plausible; stat blood gas analysis clinched the diagnosis and managed with intravenous methylene blue.http://dx.doi.org/10.1155/2019/1571423 |
| spellingShingle | Khuram Khan Irwin White-Gittens Saqib Saeed Leaque Ahmed Benzocaine-Induced Methemoglobinemia in a Postoperative Bariatric Patient following Esophagogastroduodenoscopy Case Reports in Critical Care |
| title | Benzocaine-Induced Methemoglobinemia in a Postoperative Bariatric Patient following Esophagogastroduodenoscopy |
| title_full | Benzocaine-Induced Methemoglobinemia in a Postoperative Bariatric Patient following Esophagogastroduodenoscopy |
| title_fullStr | Benzocaine-Induced Methemoglobinemia in a Postoperative Bariatric Patient following Esophagogastroduodenoscopy |
| title_full_unstemmed | Benzocaine-Induced Methemoglobinemia in a Postoperative Bariatric Patient following Esophagogastroduodenoscopy |
| title_short | Benzocaine-Induced Methemoglobinemia in a Postoperative Bariatric Patient following Esophagogastroduodenoscopy |
| title_sort | benzocaine induced methemoglobinemia in a postoperative bariatric patient following esophagogastroduodenoscopy |
| url | http://dx.doi.org/10.1155/2019/1571423 |
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