Anesthetic Management and Transient Postoperative Hyperbilirubinemia in a 16-Year-Old Male with Hereditary Spherocytosis for Cholecystectomy
Abstract
Hereditary spherocytosis (HS) is a hemolytic disorder in which perioperative stress may exacerbate hemolysis. We report the anesthetic management of a 16-year-old male with HS undergoing cholecystectomy under general anesthesia with epidural analgesia. Postoperatively, there was a transient rise in bilirubin levels without a corresponding fall in hemoglobin or clinical evidence of hemolysis. The patient remained hemodynamically stable and improved with supportive management. This case highlights that postoperative hyperbilirubinemia in HS patients is not always indicative of hemolytic crisis and should be interpreted in the appropriate clinical context.
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[3] Eber S, Lux SE. Hereditary spherocytosis--defects in proteins that connect the membrane skeleton to the lipid bilayer. Semin Hematol. 2004; 41(2):118-41.
[4] Evans C, Evans M, Pollock AV. The incidence and causes of postoperative jaundice. A prospective study. Br J Anaesth. 1974; 46(7):520-5.
[5] Ong CK, Lirk P, Tan CH, Seymour RA. An evidence-based update on nonsteroidal anti-inflammatory drugs. Clin Med Res. 2007; 5(1):19-34.
[6] Block BM, Liu SS, Rowlingson AJ, Cowan AR, Cowan JA Jr, Wu CL. Efficacy of postoperative epidural analgesia: a meta-analysis. JAMA. 2003; 290(18):2455-63.
[2] Bolton-Maggs PH, Langer JC, Iolascon A, Tittensor P, King MJ; General Haematology Task Force of the British Committee for Standards in Haematology. Guidelines for the diagnosis and management of hereditary spherocytosis--2011 update. Br J Haematol. 2012; 156(1):37-49.
[3] Eber S, Lux SE. Hereditary spherocytosis--defects in proteins that connect the membrane skeleton to the lipid bilayer. Semin Hematol. 2004; 41(2):118-41.
[4] Evans C, Evans M, Pollock AV. The incidence and causes of postoperative jaundice. A prospective study. Br J Anaesth. 1974; 46(7):520-5.
[5] Ong CK, Lirk P, Tan CH, Seymour RA. An evidence-based update on nonsteroidal anti-inflammatory drugs. Clin Med Res. 2007; 5(1):19-34.
[6] Block BM, Liu SS, Rowlingson AJ, Cowan AR, Cowan JA Jr, Wu CL. Efficacy of postoperative epidural analgesia: a meta-analysis. JAMA. 2003; 290(18):2455-63.
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| Issue | Article in Press |
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| Section | Case Report(s) | |
| Keywords | ||
| Hereditary spherocytosis Haemolysis Epidural analgesia Postoperative hyperbilirubinemia. | ||
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How to Cite
1.
Khatavkar S, Kumar S. Anesthetic Management and Transient Postoperative Hyperbilirubinemia in a 16-Year-Old Male with Hereditary Spherocytosis for Cholecystectomy. Arch Anesth & Crit Care. 2026;.
