Massive cerebral air embolism following percutaneous transhepatic biliary drainage
| Autor: | Lee, Jae Ho, Lee, Ha Young, Lim, Myung Kwan, Kang, Young Hye |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Hyperbaric Oxygenation
Portal Vein cerebral air embolism Middle Aged Biliary Tract Surgical Procedures air embolism Fatal Outcome Liver Cerebrovascular Circulation case report Drainage Embolism Air Hepatectomy Humans Female Gallbladder Neoplasms Clinical Case Report Cerebrum percutaneous transhepatic biliary drainage Digestive System Surgical Procedures Research Article |
| Zdroj: | Medicine |
| ISSN: | 1536-5964 0025-7974 |
| Popis: | Rationale: Cerebral air embolism from portal venous gas rarely occurs due to invasive procedures (e.g., endoscopic procedures, liver biopsy, or percutaneous transhepatic biliary drainage) that disrupt the gastrointestinal or hepatobiliary structures. Here, we report a rare case of fatal cerebral air embolism following a series of percutaneous transhepatic biliary drainage tube insertions. Patient Concerns: A 50-year-old woman with a history of cholecystectomy, liver wedge resection, and hepaticojejunostomy for gallbladder cancer presented with altered mental status 1 week after percutaneous transhepatic biliary drainage tube placement. Diagnoses: Extensive cerebral air embolism and acute cerebral infarction. Interventions: Brain computed tomography and magnetic resonance imaging, hyperbaric oxygen therapy, medical therapy. Outcomes: Despite the use of hyperbaric oxygen therapy and medical treatment including vasopressors, the patient eventually died due to massive systemic air embolism. Lessons: To date, there have been no reports of cerebral air embolism due to percutaneous transhepatic biliary drainage with pronounced radiologic images. We reviewed previously reported fatal cases associated with endoscopic hepatobiliary procedures and assessed the possible mechanisms and potential causes of air embolism. |
| Databáze: | OpenAIRE |
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