Singh Joya, Danko Colin
University of Texas Southwestern Medical Center, Department of Emergency Medicine, Dallas, TX.
J Educ Teach Emerg Med. 2022 Jul 15;7(3):V10-V13. doi: 10.21980/J83P9T. eCollection 2022 Jul.
This is a case report of a 55-year-old woman with a past medical history of hypertension who presented to the emergency department with upper lip and cheek swelling isolated to the right side of her face. She was on lisinopril for several years and had never had an episode of swelling in the past. Her vital signs were stable. However, on reassessment, the patient's right sided swelling progressed to the entire upper lip and she complained of swelling in her submandibular space. Although no swelling was appreciated to the submandibular space on physical exam, and the patient still did not have any signs or symptoms of respiratory distress, the decision was made to use a fiberoptic laryngoscope to evaluate her airway. Fiberoptic laryngoscope showed noticeable laryngeal edema which did not improve after treatment, and the patient was admitted to the medical intensive care unit for close airway observation. This case highlights the use of fiberoptic laryngoscope by emergency physicians in the evaluation of patients with relatively benign appearing angioedema.
ACE-I, angioedema, fiberoptic laryngoscope, laryngeal edema, tranexamic acid.
这是一例55岁女性的病例报告,该患者有高血压病史,因右侧面部上唇和脸颊肿胀就诊于急诊科。她服用赖诺普利数年,过去从未有过肿胀发作。她的生命体征稳定。然而,再次评估时,患者右侧肿胀蔓延至整个上唇,且她主诉下颌下间隙肿胀。尽管体格检查未发现下颌下间隙肿胀,且患者仍无任何呼吸窘迫的体征或症状,但还是决定使用纤维喉镜评估其气道。纤维喉镜显示有明显的喉部水肿,治疗后未改善,患者被收入医学重症监护病房进行密切气道观察。本病例突出了急诊医生使用纤维喉镜评估表现相对良性的血管性水肿患者的情况。
血管紧张素转换酶抑制剂、血管性水肿、纤维喉镜、喉部水肿、氨甲环酸