Paradoxical carbon dioxide embolism during laparoscopic cholecystectomy as a cause of cardiac arrest and neurologic sequelae: a case report
An 81-year-old male patient was scheduled for a laparoscopic cholecystectomy due to acute cholecystitis. About 50 minutes into the operation, the arterial blood pressure suddenly decreased and ventricular fibrillation appeared on the electrocardiography. The patient received cardiopulmonary resuscit...
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doaj-f7c0a3278f004bf6b90a0469fae5b8892020-11-25T03:03:03ZengKorean Society of AnesthesiologistsKorean Journal of Anesthesiology2005-64192005-75632014-12-0167642542810.4097/kjae.2014.67.6.4257965Paradoxical carbon dioxide embolism during laparoscopic cholecystectomy as a cause of cardiac arrest and neurologic sequelae: a case reportHye Young Shin0Dong Wook Kim1Ju Deok Kim2Soo Bong Yu3Doo Sik Kim4Kyung Han Kim5Sie Jeong Ryu6Department of Anesthesiology and Pain Medicine, Kosin University College of Medicine, Busan, Korea.Department of Anesthesiology and Pain Medicine, Kosin University College of Medicine, Busan, Korea.Department of Anesthesiology and Pain Medicine, Kosin University College of Medicine, Busan, Korea.Department of Anesthesiology and Pain Medicine, Kosin University College of Medicine, Busan, Korea.Department of Anesthesiology and Pain Medicine, Kosin University College of Medicine, Busan, Korea.Department of Anesthesiology and Pain Medicine, Kosin University College of Medicine, Busan, Korea.Department of Anesthesiology and Pain Medicine, Kosin University College of Medicine, Busan, Korea.An 81-year-old male patient was scheduled for a laparoscopic cholecystectomy due to acute cholecystitis. About 50 minutes into the operation, the arterial blood pressure suddenly decreased and ventricular fibrillation appeared on the electrocardiography. The patient received cardiopulmonary resuscitation and recovered a normal vital sign. We suspected a carbon dioxide embolism as the middle hepatic vein had been injured during the surgery. We performed a transesophageal echocardiography and were able to confirm the presence of multiple gas bubbles in all of the cardiac chambers. After the operation, the patient presented a stable hemodynamic state, but showed weaknesses in the left arm and leg. There were no acute lesions except for a chronic cerebral cortical atrophy and chronic microvascular encephalopathy on the postoperative brain-computed tomography, 3D angiography and magnetic resonance image. Fortunately, three days after the operation, the patient's hemiparesis had entirely subsided and he was discharged without any neurologic sequelae.http://ekja.org/upload/pdf/kjae-67-425.pdfcarbon dioxide embolismcardiopulmonary resuscitationparadoxical embolismtransesophageal echocardiography |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hye Young Shin Dong Wook Kim Ju Deok Kim Soo Bong Yu Doo Sik Kim Kyung Han Kim Sie Jeong Ryu |
spellingShingle |
Hye Young Shin Dong Wook Kim Ju Deok Kim Soo Bong Yu Doo Sik Kim Kyung Han Kim Sie Jeong Ryu Paradoxical carbon dioxide embolism during laparoscopic cholecystectomy as a cause of cardiac arrest and neurologic sequelae: a case report Korean Journal of Anesthesiology carbon dioxide embolism cardiopulmonary resuscitation paradoxical embolism transesophageal echocardiography |
author_facet |
Hye Young Shin Dong Wook Kim Ju Deok Kim Soo Bong Yu Doo Sik Kim Kyung Han Kim Sie Jeong Ryu |
author_sort |
Hye Young Shin |
title |
Paradoxical carbon dioxide embolism during laparoscopic cholecystectomy as a cause of cardiac arrest and neurologic sequelae: a case report |
title_short |
Paradoxical carbon dioxide embolism during laparoscopic cholecystectomy as a cause of cardiac arrest and neurologic sequelae: a case report |
title_full |
Paradoxical carbon dioxide embolism during laparoscopic cholecystectomy as a cause of cardiac arrest and neurologic sequelae: a case report |
title_fullStr |
Paradoxical carbon dioxide embolism during laparoscopic cholecystectomy as a cause of cardiac arrest and neurologic sequelae: a case report |
title_full_unstemmed |
Paradoxical carbon dioxide embolism during laparoscopic cholecystectomy as a cause of cardiac arrest and neurologic sequelae: a case report |
title_sort |
paradoxical carbon dioxide embolism during laparoscopic cholecystectomy as a cause of cardiac arrest and neurologic sequelae: a case report |
publisher |
Korean Society of Anesthesiologists |
series |
Korean Journal of Anesthesiology |
issn |
2005-6419 2005-7563 |
publishDate |
2014-12-01 |
description |
An 81-year-old male patient was scheduled for a laparoscopic cholecystectomy due to acute cholecystitis. About 50 minutes into the operation, the arterial blood pressure suddenly decreased and ventricular fibrillation appeared on the electrocardiography. The patient received cardiopulmonary resuscitation and recovered a normal vital sign. We suspected a carbon dioxide embolism as the middle hepatic vein had been injured during the surgery. We performed a transesophageal echocardiography and were able to confirm the presence of multiple gas bubbles in all of the cardiac chambers. After the operation, the patient presented a stable hemodynamic state, but showed weaknesses in the left arm and leg. There were no acute lesions except for a chronic cerebral cortical atrophy and chronic microvascular encephalopathy on the postoperative brain-computed tomography, 3D angiography and magnetic resonance image. Fortunately, three days after the operation, the patient's hemiparesis had entirely subsided and he was discharged without any neurologic sequelae. |
topic |
carbon dioxide embolism cardiopulmonary resuscitation paradoxical embolism transesophageal echocardiography |
url |
http://ekja.org/upload/pdf/kjae-67-425.pdf |
work_keys_str_mv |
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