Venous gas embolism during endoscopy

• Published in: Surgical endoscopy Vol. 13; no. 3; pp. 276 - 279
• Main Authors: HERRON, D. M, VERNON, J. K, GRYSKA, P. V, REINES, H. D
• Format: Journal Article
• Language: English
• Published: New York, NY Springer 01-03-1999
• Subjects: Adult; Anastomosis, Roux-en-Y; Biological and medical sciences; Catheterization - adverse effects; Constriction, Pathologic - therapy; Digestive system. Abdomen; Embolism, Air - etiology; Endoscopy; Endoscopy, Gastrointestinal - adverse effects; Female; Hepatic Veins; Humans; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; Postoperative Complications - therapy; Risk Factors; Human; Instrumentation therapy; Surgical anastomosis; Stenosis; Cardiovascular disease; Laparoscopy; Choledochojejunal; Vascular disease; Air embolism; Case study; Treatment; Pneumatic dilatation; Surgery; Digestive diseases; Intestinal disease; Complication; Female; Surgical approach; Endoscopy; Vein; Bibliographic review
• ISSN: 0930-2794; 1432-2218
• DOI: 10.1007/s004649900963

Venous gas embolism is a rare but serious complication of laparoscopic and endoscopic procedures. We describe the case of a 33-year-old woman with a strictured hepaticojejunostomy anastomosis who was treated with transabdominal endoscopic balloon dilation. During the procedure, she suffered a venous gas embolus with immediate cardiovascular collapse. After treatment with pressors, electrical cardioversion, and multiple aspirations of the right ventricle, the patient recovered fully. We reviewed all reported cases of venous gas embolism during endoscopy over the past 30 years and identified multiple risk factors. We suggest precautions to minimize future complications in patients at increased risk.