Clinical Endoscopy

Air Embolism during Upper Endoscopy: A Case Report: Yin Fang, Junbei Wu, Feng Wang, Lihong Cheng, Yunhong Lu, Xiaofei Cao; Clin Endosc 2019;52(4):365-368. Published online March 13, 2019; DOI: https://doi.org/10.5946/ce.2018.201

Air embolism is a rare complication of upper endoscopy and potentially causes life-threatening events. A 67-year-old man with a history of surgery of cardiac carcinoma and pancreatic neuroendocrine tumor underwent painless upper endoscopy because of tarry stools. During the procedure, air embolism developed, which caused decreased pulse oxygen saturation and delayed sedation recovery. He recovered with some weakness of the left upper limb in the intensive care unit without hyperbaric oxygen therapy. The etiology, clinical manifestations, and treatments of air embolism are discussed based on the literature reports. Although air embolism is uncommon in endoscopic examinations, the patients’ outcomes could be improved if clinicians are alert to this potential complication, and promptly start proper diagnostic and therapeutic measures.

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Cerebral Air Embolism after Esophagogastroduodenoscopy: Insight on Pathophysiology, Epidemiology, Prevention and Treatment
Malik Ghannam, Azizullah Beran, Dana Ghazaleh, Tanner Ferderer, Brent Berry, Mona Al Banna, Leighton Mohl, Christopher Streib, Tapan Thacker, Ivan Matos
Journal of Stroke and Cerebrovascular Diseases.2019; 28(12): 104403. CrossRef

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Two Cases of Cerebral Air Embolism That Occurred during Esophageal Ballooning and Endoscopic Retrograde Cholangiopancreatography: Suyeon Park, Ji Yong Ahn, Young Eun Ahn, Sang-Beom Jeon, Sang Soo Lee, Hwoon-Yong Jung, Jin-Ho Kim; Clin Endosc 2016;49(2):191-196. Published online February 22, 2016; DOI: https://doi.org/10.5946/ce.2015.071

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Cerebral air embolism is an extremely rare complication of endoscopic procedure and often life threatening. We present two cases of cerebral infarction due to air embolization caused by an endoscopic intervention. The first case occurred during esophageal balloon dilatation for the treatment of a stricture of an anastomosis site in a 59-year-old man and the second case occurred during endoscopic papillary balloon dilatation in a 69-year-old man who had distal common bile duct stones. After the procedure, cardiopulmonary instability and altered mental status were observed in both patients, and cerebral air embolism was diagnosed in both cases. Hyperbaric oxygen therapy was started in the first case, and high FiO₂ therapy was applied in the second case. Although this complication is rare, patient outcomes can be improved if physicians are aware of this potential complication, and immediately begin proper management.

Citations

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Rahul Shah, Saumya Shah
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Cerebral air embolism following an endoscopic variceal ligation
Xue-song Bai, Bo Yang, Yi-jun Yu, Hong-lan Liu, Zi Yin
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Fatal Cerebral Air Embolism Due to a Patent Foramen Ovale during Endoscopic Retrograde Cholangiopancreatography: Adam Bastovansky, Claudia Stöllberger, Josef Finsterer; Clin Endosc 2014;47(3):275-280. Published online May 31, 2014; DOI: https://doi.org/10.5946/ce.2014.47.3.275

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Fatal air embolism to the cerebrum during an endoscopic retrograde cholangiopancreatography (ERCP) has not been reported in a patient with a biliodigestive anastomosis and multiresistant extended-spectrum β-lactamase Escherichia coli (ESBL) bacteremia. A 59-year-old woman with a history of laparoscopic cholecystectomy and iatrogenic injury of the right choledochal duct, choledochojejunostomy (biliodigestive anastomosis), recurrent cholangitis, revision of the biliodigestive anastomosis, recurrent liver abscesses, and recurrent stenting of stenotic bile ducts, was admitted because of fever and tenderness of the right upper quadrant. On ERCP, a previously deployed covered Wallstent was replaced. Blood cultures grew ESBL. After stent removal 8 days later, the patient did not wake up and developed arterial hypotension and respiratory insufficiency, requiring mechanical ventilation. Computed tomography scans showed extensive air embolism to the liver, heart, and cerebrum. She died 1 day later. Although the exact pathogenesis of the fatal cerebral air embolism remains speculative, the nonphysiological anatomy and chronic infection with ESBL may have been contributory factors.

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The Japanese Journal of Gastroenterological Surger.2015; 48(5): 463. CrossRef

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