Anesthesia for Laparoscopic Cholecystectomy in a Patient with Hypereosinophilic Syndrome: A Case Report and Literature Review

Latifa Oumaiouf, Lamia bennis, Youssef elouardi, Mohammed khallouki.

Abstract

Background: Hypereosinophilic syndrome (HES) is a rare and heterogeneous disorder characterized by persistent eosinophilia and multi-organ involvement. Anesthetic management of patients with HES requires careful assessment of organ dysfunction to optimize perioperative care.

Case Presentation: We report the case of a 49-year-old male with HES resistant to imatinib, maintained on corticosteroid therapy (80 mg/day), who presented for laparoscopic cholecystectomy due to cholecystitis. Preoperative evaluation revealed cardiac involvement with moderate left ventricular systolic dysfunction (EF 45%), a left bundle branch block, and elevated troponin levels. Pulmonary manifestations included a history of angioedema and asthmatic coughs. General anesthesia was performed with stable hemodynamics and respiratory function. Postoperative management included multimodal analgesia, thromboprophylaxis, and continued corticosteroid therapy.

Conclusion: This case highlights the importance of a multidisciplinary approach in anesthetic management of HES patients, emphasizing cardiovascular and respiratory optimization to prevent perioperative complications.