Intraoperative Visible Bubbling of Air May Be the First Sign of Venous Air Embolism During Posterior Surgery for Scoliosis

Wills, John S.; Schwend, Richard M.; Paterson, Andrew J; Albin, Maurice S.

doi:10.1097/01.brs.0000182347.85827.0c

Cited by 28 publications

(14 citation statements)

References 35 publications

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“…Presence of visible bubbling at the operative site was usually the first clinical indication of VAE, but it can also happen without the visible bubbling. 9 There is no bubbling present in our case. A high index of suspicion could potentially save the life of the patient as a definitive diagnosis could be difficult.…”

Section: Discussionmentioning

confidence: 43%

A case of cardiac arrest due to air embolism during scoliosis surgery

Amin

Beng

Young

et al. 2019

J Orthop Surg (Hong Kong)

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Cardiac arrest during scoliosis surgery is rare in idiopathic scoliosis. We present a case of cardiorespiratory collapse during corrective surgery in a young patient with idiopathic scoliosis. A diagnosis of venous air embolism was made by exclusion. A cardiorespiratory resuscitation was performed in supine position. Patient recovered without any sequelae and had operation completed 6 weeks later.

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Section: Discussionmentioning

confidence: 43%

A case of cardiac arrest due to air embolism during scoliosis surgery

Amin

Beng

Young

et al. 2019

J Orthop Surg (Hong Kong)

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“…After surgery, mercury spread out along the spinal canal and along the venous structure to the pulmonary artery. There have been many reported cases of air embolism during operation 4,8,10,14,15) . We assumed that not only air or gas but mercury as well could be transported by vessel, if it is contacted with exposed cancellous bone during bone works.…”

Section: Discussionmentioning

confidence: 99%

Postoperative Systemic Dissemination of Injected Elemental Mercury

Kang

Park

Moon³

2011

J Korean Neurosurg Soc

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Under general anesthesia, prone position and C-arm fluoroscopic guided, midline skin incision and subperiosteal dissection to approach the right side of high cervical area was done. To avoid metal vaporization, cauterization was used cautiously. Exposed silver-colored liquid during dissection were evacuated. When right side C3 hemilaminectomy was done and ligament flavum removed, the silver-colored liquid gushed out from the spinal canal. Exposed cervical dura was thickened owing to inflammations around the dura. In the operation field, all silverlike materials were removed. Drain catheter was inserted and operation wound was closed. On the left side of the neck, because of the muscular bleeding, C-arm fluoroscopy guided nee- INTRODUCTIONThere are many reports about mercury poisoning 6) . Many people suffer from mercury poisoning in the industrial field, owing to environmental disasters, by accidents and even including suicidal trial. Various treatment options have been applied for the poisoned patients. However, surgical treatments are required in restricted state. Authors have experienced one case of injected mercury patients and report the complication after surgery with literature review. To our knowledge, it is the first report on surgery related vascular dissemination. CASE REPORTA 19-year-old man in good previous health was transferred, There were only a few reports of mercury on pulmonary artery. However, there is no data on surgery related mercury dissemination. The objective of the present article is to describe one case of postoperative injected mercury dissemination. A 19-year-old man presented severe neck pain including meningeal irritation sign and abdominal pain after injection of mercury for the purpose of suicide. Radiologic study showed injected mercury in the neck involving high cervical epidural space and subcutaneous layer of abdomen. Partial hemilaminectomy and open mercury evacuation of spinal canal was performed. For the removal of abdominal subcutaneous mercury, C-arm guided needle aspiration was done. After surgery, radiologic study showed disseminated mercury in the lung, heart, skull base and low spinal canal. Neck pain and abdominal pain were improved after surgery. During 1 month after surgery, there was no symptom of mercury intoxication except increased mercury concentration of urine, blood and hair. We assumed the bone work during surgery might have caused mercury dissemination. Therefore, we recommend minimal invasive surgical technique for removal of injected mercury. If open exposures are needed, cautious surgical technique to prohibit mercury dissemination is necessary and normal barrier should be protected to prevent the migration of mercury.J Korean Neurosurg Soc 49 : 245-247, 2011 10.3340/jkns.2011.49.4.245 Copyright © 2011 The Korean Neurosurgical Society Print ISSN 2005-3711 On-line ISSN 1598-

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“…This occurs when there is a pressure gradient between the veins at the surgical site and the heart (Palmon et al ). Spontaneous intra‐operative VAE is a life‐threatening event and a fatal outcome was reported for 10 out of 22 humans affected during spinal surgery (Wills et al ). VAE has been associated with neurosurgery performed in the sitting position and also with lumbar puncture, arthroscopy and hip arthroplasty (Mirski et al ).…”

Section: Introductionmentioning

confidence: 99%

“…VAE has been associated with neurosurgery performed in the sitting position and also with lumbar puncture, arthroscopy and hip arthroplasty (Mirski et al ). Air bubbling at the surgical site may be the first clinical indication of VAE in human patients (Wills et al ).…”

Section: Introductionmentioning

confidence: 99%

Suspected air embolism through the thoracic ventral internal vertebral venous plexus during hemilaminectomy in dogs

Mortera-Balsa

Oostrom

Yeamans

et al. 2017

J of Small Animal Practice

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Venous air embolism entering via the ventral internal vertebral venous plexus was suspected during thoracic spinal surgery in two dogs. In both cases, air was seen bubbling from a pool of blood on the floor of the vertebral canal accompanied by sudden cardiopulmonary disturbances: low end-tidal carbon dioxide pressure, tachycardia and reduction in oxygen in the blood. One dog became dyspnoeic and one died.

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Intraoperative Visible Bubbling of Air May Be the First Sign of Venous Air Embolism During Posterior Surgery for Scoliosis

Cited by 28 publications

References 35 publications

A case of cardiac arrest due to air embolism during scoliosis surgery

A case of cardiac arrest due to air embolism during scoliosis surgery

Postoperative Systemic Dissemination of Injected Elemental Mercury

Suspected air embolism through the thoracic ventral internal vertebral venous plexus during hemilaminectomy in dogs

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