Soonchunhyang Med Sci.  2021 Dec;27(2):103-105. 10.15746/sms.21.025.

Cardiac Arrest due to Carbon Dioxide Embolism During Laparoscopic Gynecologic Surgery of a Patient with Previous Abdominal Surgery: A Case Report

• Kim NS

• KMID: 2524021
• DOI: http://doi.org/10.15746/sms.21.025

Abstract

Catastrophic carbon dioxide (CO₂) embolism is a rare, but potentially life-threatening, the complication of laparoscopic gynecologic surgery. We report the case of a healthy 53-year-old woman who developed CO₂ embolism and cardiac arrest during laparoscopic surgery. She had a history of two cesarean sections and had extensive peritoneal adhesions. After placement of the trocar and insufflation of CO₂, end-tidal CO₂ dropped from 35 to 15 mm Hg, and the patient had a cardiovascular collapse. In this patient, CO₂ embolism was diagnosed on the basis of a sudden decrease in end-tidal CO₂, hypotension, and hypoxemia. The patient was managed quickly and aggressively. The patient recovered completely following the treatment for CO₂ embolism, with no cardiopulmonary or neurological sequelae. There is an increased risk of catastrophic CO₂ embolism during laparoscopic gynecologic surgery in patients with previous abdominal surgery. Therefore, the surgeon and anesthesiologist should remain vigilant to promote early detection of CO₂ embolism.

Keyword

Carbon dioxide; Embolism; Laparoscopy; Case report