Fulminant Hepatic Failure in the Course of an Outpatient Anesthetic Procedure: Sevoflurane among Other High-Risk Factors

Case Reports in Anesthesiology
Céline CheronPhilippe Hantson

Abstract

A 20-year-old man underwent an outpatient general anesthetic procedure with sevoflurane for the correction of a bilateral gynecomastia. The patient had been first exposed to sevoflurane two years before, without any complication. He presented an overweight with a body mass index (BMI) of 31.4 kg/m2 and had an episode of "binge" drinking a few days before anesthesia. He became icteric from postoperative day 9, and after the worsening of liver function tests, the liver biopsy revealed centrilobular necrosis. The patient became encephalopathic and required urgent liver transplantation on postoperative day 30. The possibility of a sevoflurane-related fulminant hepatic failure is discussed.

References

Dec 1, 1995·Anesthesia and Analgesia·E D Kharasch
Jul 29, 2003·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Maurice G EmeryKenneth E Thummel
Feb 3, 2005·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Jackie L Martin
May 21, 2009·American Journal of Therapeutics·Shashideep SinghalKris Anand
Aug 16, 2013·Liver International : Official Journal of the International Association for the Study of the Liver·Jonathan LinAmanda Nicoll
Dec 3, 2014·Redox Biology·Salvatore SuttiEmanuele Albano
Dec 22, 2014·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Saleh A AlqahtaniUNKNOWN Drug-Induced Liver Injury Network (DILIN) Study Investigators
Apr 29, 2015·Journal of Hepatology·Minjun ChenM Isabel Lucena

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