A CASE OF ANAPHYLACTIC SHOCK CAUSED BY FIBRIN GLUE DURING LOBECTOMY

We experienced a rare case of anaphylactic shock probably caused by topical application of fibrin glue. A 74-year-old woman was suspected to have primary lung cancer in clinical stage IA(cT1aN0M0). After video-assisted partial resection,intraoperative rapid diagnosis was primary lung cancer. Right upper lobectomy and lymph node dissection were thus performed. The bronchial stump was covered by poly-glycolic acid sheet and fibrin glue. After spraying fibrin glue,the patient developed skin rash of the whole body and went into shock. Anaphylactic shock caused by topical application of fibrin glue was diagnosed. Immediately steroid and epinephrine were given,and poly-glycolic acid sheet and fibrin glue were removed as far as possible. Sustained venous administration of dopamine and norepinephrine was required for almost 24 hours. Drug-induced lymphocyte stimulation test revealed a highly elevated value for fibrinogen solution.