A 35-year-old woman developed abdominal compartment syndrome secondary to postoperative ileus while receiving hydromorphone analgesia; diphenhydramine may have contributed to her bowel dysfunction.
The woman underwent ileal neobladder reconstruction. She started hydromorphone patient-controlled analgesia (PCA) on postoperative day 1 [route and dosage not stated], supplemented with ketorolac and dexmedetomidine. She developed a ketorolac allergy; ketorolac and dexmedetomidine were withdrawn. She was treated with several diphenhydramine doses [route, dosage and duration of treatment to reaction onset not stated], and her rash resolved....