Acute hepatitis following enflurane anaesthesia

Area of Science:

• Hepatology
• Anesthesiology
• Clinical Toxicology

Background:

• Postoperative liver injury can occur following general anesthesia.
• Inhalational anesthetics like enflurane and halothane are known, albeit rare, causes of drug-induced hepatitis.
• Differential diagnosis of postoperative hepatitis is crucial to identify the causative agent.

Observation:

• A patient presented with fever and acute hepatitis soon after receiving enflurane anesthesia.
• Standard investigations ruled out other common causes of postoperative hepatitis.
• The clinical presentation raised suspicion for anesthetic-induced liver injury.

Findings:

• Enflurane anesthesia was identified as the likely trigger for acute hepatitis in this patient.
• Evidence suggests a potential cross-sensitization between enflurane and halothane.
• The hepatitis might have been exacerbated by a prior or concurrent exposure to halothane.

Implications:

• This case highlights the importance of considering anesthetic agents in the differential diagnosis of postoperative hepatitis.
• The possibility of cross-sensitization between enflurane and halothane warrants further investigation.
• Clinicians should be vigilant for hepatotoxicity when using these agents, especially in patients with a history of anesthetic-related liver issues.