Clin Endosc.  2019 Jul;52(4):365-368. 10.5946/ce.2018.201.

Air Embolism during Upper Endoscopy: A Case Report

• Fang Y
• Wu J
• Wang F
• Cheng L
• Lu Y
• Cao X

• KMID: 2455634
• DOI: http://doi.org/10.5946/ce.2018.201

Abstract

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.

Keyword

Embolism, air; Upper endoscopy; Complication

MeSH Terms

Aged
Embolism, Air*
Endoscopy*
Heart Neoplasms
Humans
Hyperbaric Oxygenation
Intensive Care Units
Neuroendocrine Tumors
Oxygen
Upper Extremity
Oxygen

Figure

• 

  Fig. 1. Endoscopic images. (A) The entrance of the diverticulum formed by the closed orifice of cardiac carcinoma surgery. (B) The diverticulum with brown blood clots inside. (C) A protuberance 40 cm from the incisor teeth. (D) The protuberance was proved to be cystic on endoscopic ultrasonography. (E) The diverticulum with active bleeding after flushing out the brown blood clots.

• 

  Fig. 2. Imaging examinations. (A) Computed tomography (CT) scan showing sporadic multiple air emboli in the left and right frontal and parietal lobes of the brain (arrow). (B) CT scan showing diffused gas density shadows mainly at the edge of the liver (arrows). (C) Magnetic resonance scan showing sporadic multiple hyperintense signals in the frontal and parietal lobes in T2-weighted images (arrow).

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