Fatal Cerebral Air Embolism Due to a Patent Foramen Ovale during Endoscopic Retrograde Cholangiopancreatography
Clinical Endoscopy
;
: 275-280, 2014.
Artigo
em Inglês
| WPRIM
| ID: wpr-193049
ABSTRACT
Fatal air embolism to the cerebrum during an endoscopic retrograde cholangiopancreatography (ERCP) has not been reported in a patient with a biliodigestive anastomosis and multiresistant extended-spectrum beta-lactamase Escherichia coli (ESBL) bacteremia. A 59-year-old woman with a history of laparoscopic cholecystectomy and iatrogenic injury of the right choledochal duct, choledochojejunostomy (biliodigestive anastomosis), recurrent cholangitis, revision of the biliodigestive anastomosis, recurrent liver abscesses, and recurrent stenting of stenotic bile ducts, was admitted because of fever and tenderness of the right upper quadrant. On ERCP, a previously deployed covered Wallstent was replaced. Blood cultures grew ESBL. After stent removal 8 days later, the patient did not wake up and developed arterial hypotension and respiratory insufficiency, requiring mechanical ventilation. Computed tomography scans showed extensive air embolism to the liver, heart, and cerebrum. She died 1 day later. Although the exact pathogenesis of the fatal cerebral air embolism remains speculative, the nonphysiological anatomy and chronic infection with ESBL may have been contributory factors.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Respiração Artificial
/
Insuficiência Respiratória
/
Beta-Lactamases
/
Ductos Biliares
/
Edema Encefálico
/
Coledocostomia
/
Pressão Intracraniana
/
Stents
/
Colangite
/
Colangiopancreatografia Retrógrada Endoscópica
Limite:
Feminino
/
Humanos
Idioma:
Inglês
Revista:
Clinical Endoscopy
Ano de publicação:
2014
Tipo de documento:
Artigo
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