Anaphylactic reactions to iodinated contrast agents during intraoperative cholangiography (IOC) are extremely rare, although such reactions are well documented with intravenous (IV) administration. We present the case of a 71-year-old female with a known allergy to iodinated contrast, who experienced a life threatening anaphylactic reaction immediately after intraoperative cholangiography (IOC) during laparoscopic cholecystectomy. Shortly after the administration of iodinated contrast into the biliary duct, the patient developed supraventricular tachycardia and profoundhypotension. This case underscores the risk of systemic absorption and hypersensitivity reactions from biliary-administered contrast agents, even in the absence of intravenous exposure. It highlights the need for a comprehensive preoperative allergy evaluation in high-risk patients undergoing biliary procedures and the importance of considering alternative imaging methods to avoid serious complications.
Hamdar et al. (Tue,) studied this question.
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