Rectal stump lavage: simple procedure resulting in life-threatening complication

Area of Science:

• Surgery
• Allergology
• Pharmacology

Background:

• Rectal stump lavage with chlorhexidine is standard in colorectal surgery to reduce bacterial load and anastomotic recurrence.
• Chlorhexidine is a widely used disinfectant due to its potent bactericidal and cytotoxic properties.

Observation:

• A patient undergoing colorectal resection developed life-threatening anaphylaxis following rectal stump lavage with chlorhexidine.
• This represents the first reported instance of severe hypersensitivity to chlorhexidine in this specific surgical context.

Findings:

• The study identifies chlorhexidine as a potential hidden allergen in surgical settings.
• The case underscores the risk of developing chlorhexidine allergy, even with its common application.

Implications:

• Clinicians should be vigilant about the potential for chlorhexidine-induced anaphylaxis in patients undergoing colorectal surgery.
• This finding necessitates a re-evaluation of safety protocols and consideration of alternative irrigation solutions.