Rectal Stump Lavage: Simple Procedure Resulting in Life-threatening Complication

• Main Authors: Shirley Y.W. Liu, Janet Fung-Yee Lee, Simon S.M. Ng, Jimmy C.M. Li, Raymond Y.C. Yiu
• Format: Article
• Language: English
• Published: Elsevier 2007-01-01
• Series: Asian Journal of Surgery
• Subjects: allergy; anaphylaxis; chlorhexidine; rectal lavage; rectal washout
• Online Access: http://www.sciencedirect.com/science/article/pii/S1015958409601329

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.