An Unusual Presentation of Gas Embolism during ERCP
DOI:
https://doi.org/10.4103/kaj/2020/v18i1-2/164242Keywords:
Clinical Suspicion, Endoscopic Retrograde Cholangio-Pancreatography (ERCP), Gas EmbolismAbstract
Gas embolism is a potentially life-threatening rare complication during endoscopy procedures. It is difficult to diagnose and clinical suspicion remains the key for diagnosis and management of gas embolism. During ERCP a patient developed cardiovascular and neurological adverse events, with paradoxical gas embolism being the most likely cause.Downloads
References
Lanke G, Adler DG. Gas embolism during endoscopic retrograde cholangiopancreatography: Diagnosis and management. Ann Gastroenterol, 2019; 32:156-167. https://doi.org/10.20524/aog.2019.0339. PMid:30837788.
Loperfido S, Angelini G, Benedetti G, et al. Major early complications from diagnostic and therapeutic ERCP: A prospective multicenter study. Gastrointest Endosc, 1998; 48:1-10. https://doi.org/10.1016/S0016-5107(98)70121-X.
Durant TM, Long J, Oppenheimer MJ. Pulmonary (venous) air embolism. Am Heart J, 1947; 33:269-281. https://doi.org/10.1016/0002-8703(47)90656-X.
Lynch JJ, Schuchard GH, Gross CM, Wann LS. Prevalence of right-to-left atrial shunting in a healthy population: detection by Valsalva maneuver contrast echocardiography. Am J Cardiol, 1984; 53:1478-1480. https://doi.org/10.1016/S0002-9149(84)91617-5.
Romberg C. Systemic air embolism after ERCP: A case report and review of the literature. Gastrointest Endosc, 2009; 70:1043-1045. https://doi.org/10.1016/j.gie.2009.03.028. PMid:19577747.
Nayagam J, Ho KM, Liang J. Fatal systemic air embolism during endoscopic retrograde cholangio-pancreatography. Anaesth Intensive Care, 2004; 32:260-264. https://doi.org/10.1177/0310057X0403200217. PMid:15957727.
Gómez C, Cuyà sB, Bazaga S, Iborra G, Murzi M. Endoscopic retrograde cholangiopancreatography-related air embolism in a patient with an unknown biliary -Venous fistula and patent foramen ovale: A case report. Ann Clin Case Rep, 2016; 1:1118.
Mathew J, Parker C, Wang J. Pulseless electrical activity arrest due to air embolism during endoscopic retrograde cholangiopancreatography: A case report and review of the literature. BMJ Open Gastro, 2015; 2:e000046. https://doi.org/10.1136/bmjgast-2015-000046. PMid:26462286 PMCid:PMC4599162.
Mirski MA, Lele AV, Fitzsimmons L, Toung TJ. Diagnosis and treatment of vascular air embolism. Anesthesiology, 2007; 106:164-177. https://doi.org/10.1097/00000542-200701000-00026. PMid:17197859.
Rademaker BMP, Groenman FA, van der Wouw PA, Bakkum EA. Paradoxical gas embolism by transpulmonary passage of venous emboli during hysteroscopic surgery: A case report and discussion. Br J Anaesth, 2008; 101:230- 233. https://doi.org/10.1093/bja/aen138. PMid:18524782.