Related Experiment Video
Updated: Mar 18, 2026
Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management
Published on: November 21, 2017
Post-Operative Malignant Hyperthermia in a Child after Colon Interposition
Sevtap Hekimoğlu Şahin1, Mustafa İnan2, Burhan Aksu2
1Department of Anaesthesiology and Reanimation, Trakya University Faculty of Medicine, Edirne, Turkey.
Insights
Malignant hyperthermia (MH), a rare anesthesia complication, occurred late in a 2-year-old boy after esophageal replacement surgery. Despite dantrolene treatment, the patient experienced fatal cardiopulmonary arrest, highlighting post-operative MH risks.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Critical Care Medicine
Background:
- Malignant hyperthermia (MH) is a rare, life-threatening pharmacogenetic disorder of skeletal muscle.
- It is a known complication of volatile anesthetic agents and succinylcholine.
- Late-onset MH, particularly post-operatively, is less common but remains a critical concern.
Observation:
- A 2-year-old boy underwent colon interposition for esophageal replacement under sevoflurane anesthesia.
- The patient developed late-onset malignant hyperthermia post-operatively.
- Initial treatment included intravenous dantrolene sodium, cooling, and controlled ventilation.
Findings:
- Despite aggressive management, the patient progressed to cardiopulmonary arrest 21 hours after surgery.
- The case demonstrates a fatal outcome in a pediatric patient with late-onset MH.
- Ischemia-reperfusion injury associated with major surgery may be a contributing factor.
Implications:
- This case underscores the importance of recognizing and managing post-operative malignant hyperthermia, even in late-onset presentations.
- Surgeons and anesthesiologists should consider the potential for MH in patients undergoing extensive procedures with potential for ischemia-reperfusion.
- Vigilance and prompt treatment are crucial for improving outcomes in malignant hyperthermia events.
Abstract:
Malignant hyperthermia (MH) is a rare and potentially life threatening fatal complication of anaesthesia. We present a 2-year-old boy with late onset MH after colon interposition to replace the oesophagus under sevoflurane anaesthesia. The patient was treated with intravenous dantrolene sodium as well as cooling and controlled ventilation. Despite treatment, the patient developed cardiopulmonary arrest at 21 hours after the operation and died. It should be kept in mind that post-operative MH may develop during these types of operations with ischaemia-reperfusion injuries.
