Arterial Gas Emboli Secondary to Portal Venous Gas Diagnosed With Point-of-Care Ultrasound: Case Report and Literature Review

Aquino-Jose, Victor M.; Johnson, Steven; Quinn, Michael; Havryliuk, Tatiana

doi:10.1016/j.jemermed.2020.06.060

Cited by 4 publications

(4 citation statements)

References 21 publications

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“…4 ). These findings are consistent with those in prior case reports of air emboli diagnosed using POCUS, including dilatation of the RV and the presence of gas bubbles moving between heart chambers [ [10] , [11] , [12] ]. Of note, it is possible that the air bubbles noted in our case are due to infusion of medications in the setting of low cardiac output state.…”

Section: Discussionsupporting

confidence: 92%

Fatal venous air embolism in the setting of hemodialysis and pulmonary hypertension: A point of care ultrasound diagnosis

Alzghoul

Jin

Vahdatpour

et al. 2023

Respiratory Medicine Case Reports

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Section: Discussionsupporting

confidence: 92%

Fatal venous air embolism in the setting of hemodialysis and pulmonary hypertension: A point of care ultrasound diagnosis

Alzghoul

Jin

Vahdatpour

et al. 2023

Respiratory Medicine Case Reports

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“…For this purpose, ultrasonography is very sensitive at identifying air bubbles that may be undetectable on CT scan [ 2 , 4 , 5 ]. Transthoracic and transesophageal echocardiogram may detect a vascular air volume as small as 0.05 mL/kg and 0.02 mL/kg, respectively [ 11 ]. A great advantage of POCUS applications is that ultrasound is a readily available bedside tool that could be used quickly for non-quantitative variables, allowing the identification of signs that may suggest cardiopulmonary compromise secondary to gas emboli migration such as dilatation of the right ventricle and inferior vena cava’s diameter.…”

Section: Discussionmentioning

confidence: 99%

“…A great advantage of POCUS applications is that ultrasound is a readily available bedside tool that could be used quickly for non-quantitative variables, allowing the identification of signs that may suggest cardiopulmonary compromise secondary to gas emboli migration such as dilatation of the right ventricle and inferior vena cava’s diameter. In severe cases, it would also detect abnormalities in the ventricular wall motion or right ventricular dysfunction [ 5 , 6 , 11 , 12 ]. Any time that bubbles are found in both cardiac chambers, the clinician must consider the possibility of left side embolism with the risk of a cerebrovascular acute event, but also the mesenteric or renal arterial tree compromise.…”

Section: Discussionmentioning

confidence: 99%

Paradoxical venous air embolism detected with point-of-care ultrasound: a case report

2022

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Venous air embolism (VAE) is an uncommon event consistent in the entrainment of air from any communication between the environment and the venous vasculature that could occur during central venous catheter (CVC) manipulation, and might trigger circulatory shock within minutes depending on the amount of air embolized. We present a case of a critical care patient who presented sudden clinical hemodynamic deterioration after the removal of central venous catheter. Hemodynamic evaluation with point-of-care ultrasound (POCUS) showed bubbles in both right and left heart cavities wherewith air embolism facilitated by heart septal defect was suspected. Therefore, the patient was reintubated, supported with vasopressors and a new CVC was inserted to proceed with air aspiration. Shortly after, the patient’s hemodynamic status improved in terms of vital signs stabilization. 6 h after the event with optimal perfusion markers and diminished sedation, the patient showed left hemiparesis therefore a cerebral magnetic resonance (MRI) was also performed showing hyperintensity in the right precentral gyrus, so ischemic stroke without hemorrhagic transformation diagnosis was made, because of paradoxical embolism. This case report demonstrates the value of POCUS application as a diagnostic tool in the hemodynamically unstable patient.

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“…Because of the generally higher sensitivity, CT is the recommended investigation when suspecting HPVG, if available [ 16 ]. When smaller quantities of gas enter the portal venous territory, though, the ultrasound examination is regarded as the better option [ 17 ]. Considerable attention must be paid to the differential diagnosis of HPVG with pneumobilia (PB) when the air has already reached the liver [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Decoding Hepatic Portal Venous Gas: A Case Report

Dogaru,

Gheoca Mutu,

Ursuț

et al. 2024

Cureus

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Hepatic portal venous gas (HPVG) is an infrequent and life-threatening condition with high morbidity and mortality rates, which consists of the presence of gas in the portal vein and its branches. Improvements in imaging technologies have led to the diagnosis of HPVG in less severe circumstances, which, in turn, has only determined a small amelioration of the prognosis. We present a rare case of HPVG subsequent to paralytic ileus in a patient who attained long-term survival after the surgical treatment was performed. HPVG is considered to be associated with sepsis, parietal/mucosal damage, inflammation of the intraperitoneal organs, and meteorism, which may be found in a variety of pathologies. The severity of this pathology depends on the pre-existing conditions of the patients but also on how quickly a treatment plan is established and applied. As a correct and timely diagnosis is crucial for the increase of the survival rate in HPVG, greater attention shall be paid to the clinical manifestations and the differential diagnosis.

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Arterial Gas Emboli Secondary to Portal Venous Gas Diagnosed With Point-of-Care Ultrasound: Case Report and Literature Review

Cited by 4 publications

References 21 publications

Fatal venous air embolism in the setting of hemodialysis and pulmonary hypertension: A point of care ultrasound diagnosis

Fatal venous air embolism in the setting of hemodialysis and pulmonary hypertension: A point of care ultrasound diagnosis

Paradoxical venous air embolism detected with point-of-care ultrasound: a case report

Decoding Hepatic Portal Venous Gas: A Case Report

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