Thursday, July 21, 2011


You are in General Surgery Clinic and you see a woman who has allergies to kiwi, banana, peach, avocado, chestnut, fig, bell pepper, tomato, and white potatoes. You roll your eyes. You ask what happens, and she says her throat swells up, she feels lightheaded, and she breaks out into generalized hives. She pulls two Epi-Pens from her pocket. She is scheduled for a laparoscopic hernia repair.

You present this case to your attending who, prior to being a surgeon, completed a medicine residency and an allergy and immunology fellowship. "Ah," she says, "11% of these patients will be sensitive to something in the operating room. And conversely, 35% of people who have that sensitivity show one of those food allergies." She draws the diagram shown above.

Challenge: When you call the operating room to schedule this case, you make sure they know she could have a reaction to...what?

P.S. Despite being Californian, your attending does not use organic locally harvested sustainable eco-friendly kiwi-skin meshes for her hernia repairs.

Image shown under Fair Use.


Anonymous said...


tree said...

Even though I have this contact allergy, I am super glad I'm not allergic to those foods, especially peach and avocado :)

Craig Chen said...

very astute!

This case describes latex-fruit syndrome; exposure to latex allergens may sensitize individuals to plant foods, especially fresh fruit, and anaphylactic reactions are not uncommon.

Source: UpToDate.