Cases reported "Embolism, Air"

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1/66. Fatal carbon dioxide embolism as an unreported complication of retroperitoneoscopy.

    Retroperitoneoscopy has gained popularity because it offers a safe alternative to the more debilitating open approach and avoids postoperative ileus. However, this type of procedure carries certain disadvantages in terms of intraperitoneal effusions and hemodynamic changes. Major complications are exceptional. We describe the case of a 52-year-old man who died of carbon dioxide embolism during elective totally extraperitoneal (TEP) inguinal hernioplasty for symptomatic left indirect inguinal hernia. With the patient under general anesthesia, the retroperitoneal space was gained through a 1. 5-cm incision made below the umbilicus. During the dissection, the patient collapsed and could not be resuscitated. At autopsy, air bubbles were admixed with blood in the epicardial veins, but no injury to vessels was demonstrated. We conclude that carbon dioxide embolism usually is caused by direct puncture of major vessels during intra-abdominal procedures. However, when this complication occurs during retroperitoneoscopy, it seems related to pressure-forced entry of carbon dioxide into the venous plexus.
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2/66. Paradoxical air embolism during orthoptic liver transplantation: diagnosis by transoesophageal echocardiography.

    We describe a case of paradoxical air embolism during orthotopic liver transplantation, early diagnosis, using intra-operative transoesophageal echocardiography after a circulatory failure, allowed early management by hyperbaric oxygen therapy.
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3/66. Portal venous gas associated with splenic abscess secondary to colon cancer.

    We report a successfully treated case accompanied by portal venous gas, which was associated with splenic abscess due to penetration of colon cancer. In June, 1998, a 67-year-old Japanese man was referred to our hospital because of a continuous fever over 40 degrees C and portal venous gas detected by computed tomography (CT). CT revealed low density areas in the spleen and wall thickening of the descending colon next to the spleen. barium-enema examination demonstrated an extrinsic filling defect in the splenic flexure of the colon. splenectomy, resection of the pancreatic tail and left hemicolectomy were performed Histopathological studies showed moderately differentiated adenocarcinoma, which made a fistula at the bottom of the ulceration to the spleen. The postoperative course was uneventful. The portal venous gas was likely to have resulted from a bacterial infection in the portal venous systems secondary to the splenic abscess.
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4/66. Presumptive delayed gas embolism after laparoscopic cholecystectomy.

    A 50-year-old woman, with a history of arterial hypertension treated with beta-blocker and Ca-antagonist, presented cardiac arrest 6 hours after elective laparoscopic cholecystectomy. During surgical intervention, arterial hypotension without any respiratory change was observed. dyspnea, asthenia and anxiety were the clinical signs appearing approximately 2 hours before cardiac arrest. After resuscitation, myocardial infarction, dissecting thoracic aortic aneurysm and major pulmonary thromboembolism were excluded. The signs of increased resistance to the right ventricular outflow and the relevant alteration of coagulation tests, lasting only a few hours, suggested venous gas embolism. Subsequently, the patient presented a cortical blindness, persisting at hospital discharge. The anesthetists should be aware about the complication that we observed after laparoscopic surgery. The least sign of cardiorespiratory instability appearing in the postoperative period must be taken into account and signal the need for increased monitoring.
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keywords = operative
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5/66. Successful treatment of massive arterial air embolism during open heart surgery.

    We report a case of a 5-year-old girl who suffered a massive arterial air embolism during surgical closure of an atrial septal defect. The risk of permanent neurologic deficits or even fatal outcome is significant (mortality rate, 31%). We successfully treated a proven arterial air embolism with intraoperative (retrograde cerebral perfusion) combined with postoperative procedures (deep barbiturate anesthesia and hyperbaric oxygenation). At discharge the girl had fully recovered from the initial neurologic defects.
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ranking = 2
keywords = operative
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6/66. A dynamic bubble trap reduces microbubbles during cardiopulmonary bypass: a case study.

    Microemboli passing to the cerebral circulation during cardiopulmonary bypass can contribute to postoperative neurologic dysfunction. Many studies conclude that air microbubbles predominantly are responsible for this problem. A dynamic bubble trap (DBT) was developed to diminish the number of microbubbles in the arterial line of extracorporeal circulation. The DBT is able to substantially reduce the number of air microbubbles, as shown in two patients undergoing coronary artery bypass grafting, where a high number of microbubbles was assessed. Although a 40-micron arterial filter was used, many bubbles larger than 40 microns occurred in the arterial line. The DBT reduced the number of large microbubbles from 2,267 to 67 in patient 1 and from 897 to 61 in patient 2.
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7/66. Repeated attacks of venous air embolism during craniotomy--a case report.

    Venous air embolism (VAE) is not uncommon during craniotomy, but repeated attacks of VAE during a single surgical procedure is rarely seen. We report a successful intraoperative management of repeated attacks of air embolism in a patient who sustained craniotomy for intracranial hemorrhage (ICH) in prone position. A 70-year-old male suffering from hemorrhage in the right cerebellar hemisphere with impending brainstem herniation was scheduled for craniotomy. He had history of hypertension but it was not well controlled with medical treatment. Emergent craniotomy for removal of blood clot resulting from ICH was performed. During the operation, sudden decrease of end-tidal CO2 (EtCO2) level, fall of blood pressure and increase of central venous pressure (CVP) were noted. Since air bubbles were retrieved from CVP catheter venous air embolism was highly suspected. With prompt diagnosis and proper management, we successfully improved the patient's hemodynamic status and he was discharged without any sequelae. Early detection together with aggressive treatment is the only way in the management of intraoperative venous air embolism.
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ranking = 2
keywords = operative
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8/66. Cerebral arterial air embolism following CT-guided lung needle marking. Report of a case.

    We report a case of survival following a temporary cerebral air embolism, which occurred immediately after CT guided lung needle marking. A 24-year-old man was referred to our hospital for resection of a pulmonary nodule. To localize the tumor, lung needle marking under CT guidance was performed. Almost immediately, the patient experienced symptoms of cerebral arterial air embolism. The following day, the symptoms diminished, and a brain CT showed no abnormal lesions. A video-assisted thoracoscopic wedge resection was performed as scheduled, the patient's postoperative course was uneventful, and he was discharged in relatively good condition.
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keywords = operative
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9/66. Left-sided cardiac gas embolism produced by hydrogen peroxide: intraoperative diagnosis using transesophageal echocardiography.

    IMPLICATIONS: We present a case of an adult who suffered a left-sided gas embolism after surgical lavage of the thoracic cavity with hydrogen peroxide. An intraoperative diagnosis was made using transesophageal echocardiography.
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ranking = 5
keywords = operative
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10/66. cavernous sinus thrombosis and air embolism following surgery for acoustic neurinoma: a case report.

    A 55 year old male patient was operated on for a massive and vascular acoustic neurinoma in a sitting position. The tumor was completely excised. Post-operatively, the patient developed irritability and clinical features suggestive of contralateral cavernous sinus thrombosis. CT scan showed air within the dural walls of the cavernous sinus on the side of surgery. However, there was no radiological evidence of cavernous sinus thrombosis on the contralateral side. cavernous sinus thrombosis as a post-surgery complication has not been reported. air within the dural confines of the cavernous sinus has also not been observed or radiologically recorded in the literature.
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keywords = operative
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