Infarto encefálico por embolia aérea: Caso clínico

Abstract

que los eventos cerebrovasculares no son comunes durante la endoscopia y que su diagnóstico debe ser efectuado precozmente para iniciar su tratamiento específico.Describimos una paciente que presentó un accidente vascular encefálico debido a una embolia aérea arterial secundaria a un procedimiento endoscópico.CASO CLÍNICO Paciente mujer de 52 años con cáncer de ovario III C (adenocarcinoma mal diferenciado) diagnosticado 2 años antes. Su tratamiento consistió en una histerec-

Massive fatal cerebral air embolism as a negative contrast angiogram

“…Gas may get into the peripheral venous circulation, the right heart and then the left heart (paradoxical embolism) as one of the following mechanisms: open foramen ovale,1 cardiac or pulmonary shunts.…”

“…The other possibility is the direct introduction of gas into the pulmonary veins, by means of barotrauma or procedures that may cause pleurovascular,2 bronchovascular3 or oesophagovascular fistulas 1. There have been cases described following pulmonary biopsy,3 4 use of venous catheters,5 angiography6 and even related to contrast injection 7.…”

“…Treatment includes haemodynamic support and hyperbaric oxygen therapy 1 4. This entity carries a mortality rate of up to 23% 7 10…”

Clinical Presentation, Diagnosis, and Management of Air Embolism During Endoscopic Retrograde Cholangiopancreatography

“…Treatment of air embolism should be started early in suspected cases, and it should be in the differential diagnoses of various complications secondary to high-risk ERCP, especially if a cardiopulmonary compromise is present [8]. Management of VAE is conservative with intravenous (IV) antibiotics and decompression via nasogastric tube [10]. If air embolism becomes evident during the procedure, the procedure should be discontinued, and hemodynamic and respiratory stabilization should be performed [45].…”

“…Its severity is related to both the amount and the velocity with which the air is introduced [8, 9]. The amount of air that causes a circulatory air embolism ranges from 10 to 480 mL, depending on the speed of air entering into circulation and the organ vasculature into which the embolus extends [10]. Air embolism is a serious complication that can occur during an endoscopic procedure, and it can cause significant morbidity and mortality if not diagnosed early [11].…”