Abstract
Abstract
Background
Bleeding and carbon dioxide (CO2) gas embolism have been reported as serious complications associated with laparoscopic surgery. We present a case of cerebral infarction presumably caused by CO2 gas embolism during laparoscopic hepatectomy.
Case presentation
During liver resection, the end-tidal CO2 suddenly dropped from 40 to 21 mmHg. Simultaneously, ST elevation in lead II and ST depression in lead V5 of the electrocardiogram were observed. After improvement of these electrocardiographic changes, surgery was continued. Postoperatively, incomplete paralysis was present in the right arm and leg. Magnetic resonance imaging revealed cerebral infarction in the broad area of the left cerebral cortex. These complications might have been caused by paradoxical embolism.
Conclusion
We should always keep in mind the risk of cerebral infarction with neurological deficits in the case of laparoscopic surgery. Careful monitoring and appropriate treatment for gas embolism are necessary during laparoscopic surgery.
Publisher
Springer Science and Business Media LLC
Subject
Anesthesiology and Pain Medicine
Reference12 articles.
1. Shin HY, Kim DW, Kim JD, Yu SB, Kim DS, Kim KH, Ryu SJ. Paradoxical carbon dioxide embolism during laparoscopic cholecystectomy as a cause of cardiac arrest and neurologic sequelae: a case report. Korean J Anesthesiol. 2014;67:425–8.
2. Kawahara T, Hagiwara M, Takahashi H, Tanaka M, Imai K, Sawada J, Kunisawa T, Furukawa H. Cerebral infarction by paradoxical gas embolism during laparoscopic liver resection with injury of the hepatic vessels in a patient without a right-to-left systemic shunt. Am J Case Rep. 2017;18:687–91.
3. Kim CS, Liu J, Kwon JY, Shin SK, Kim KJ. Venous air embolism during surgery, especially cesarean delivery. J Korean Med Sci. 2008;23:753–61.
4. Scoletta P, Morsiani E, Ferrocci G, Maniscalco P, Pellegrini D, Colognesi A. Azzena G: [Carbon dioxide embolization: is it a complication of laparoscopic cholecystectomy? ]. Minerva Chir. 2003;58:313–20.
5. Park EY, Kwon JY, Kim KJ. Carbon dioxide embolism during laparoscopic surgery. Yonsei Med J. 2012;53:459–66.
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