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When in Trouble Think of the Bubble: Paradoxical Cerebral Arterial Gas Embolism after Endoscopic Retrograde Cholangiopancreatography

Air embolism (a result of direct communication with the vasculature and an external pressure gradient from the gastrointestinal or the biliary tract), although rare, is a potentially devastating adverse event seen in endoscopic retrograde cholangiopancreatography (ERCP) procedures. Whether venous, a...

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Autores principales: Ekmektzoglou, Konstantinos, Alexandrakis, Georgios, Dimopoulos, Konstantinos, Tsibouris, Panagiotis, Kalantzis, Chrysostomos, Vlachou, Erasmia, Apostolopoulos, Periklis
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8138231/
https://www.ncbi.nlm.nih.gov/pubmed/34054400
http://dx.doi.org/10.1159/000514706
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author Ekmektzoglou, Konstantinos
Alexandrakis, Georgios
Dimopoulos, Konstantinos
Tsibouris, Panagiotis
Kalantzis, Chrysostomos
Vlachou, Erasmia
Apostolopoulos, Periklis
author_facet Ekmektzoglou, Konstantinos
Alexandrakis, Georgios
Dimopoulos, Konstantinos
Tsibouris, Panagiotis
Kalantzis, Chrysostomos
Vlachou, Erasmia
Apostolopoulos, Periklis
author_sort Ekmektzoglou, Konstantinos
collection PubMed
description Air embolism (a result of direct communication with the vasculature and an external pressure gradient from the gastrointestinal or the biliary tract), although rare, is a potentially devastating adverse event seen in endoscopic retrograde cholangiopancreatography (ERCP) procedures. Whether venous, arterial, or paradoxical, the clinical presentation ranges from asymptomatic patients to cardiorespiratory arrest. This is of particular importance because it makes the diagnosis of air embolism even more difficult in an already sedated patient. Since early recognition increases the chances of patients' survival, endoscopists should be highly motivated and trained to recognize this complication as early as possible. With only 60 cases of air embolism reported (and even fewer related to paradoxical air embolism), we aimed to report a case of paradoxical cerebral air embolism in a patient undergoing ERCP due to a common bile duct stricture and to provide a mini-review of this clinical entity that can serve as a bedside quick reference guide for endoscopists worldwide.
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spelling pubmed-81382312021-05-27 When in Trouble Think of the Bubble: Paradoxical Cerebral Arterial Gas Embolism after Endoscopic Retrograde Cholangiopancreatography Ekmektzoglou, Konstantinos Alexandrakis, Georgios Dimopoulos, Konstantinos Tsibouris, Panagiotis Kalantzis, Chrysostomos Vlachou, Erasmia Apostolopoulos, Periklis Case Rep Gastroenterol Case and Review Air embolism (a result of direct communication with the vasculature and an external pressure gradient from the gastrointestinal or the biliary tract), although rare, is a potentially devastating adverse event seen in endoscopic retrograde cholangiopancreatography (ERCP) procedures. Whether venous, arterial, or paradoxical, the clinical presentation ranges from asymptomatic patients to cardiorespiratory arrest. This is of particular importance because it makes the diagnosis of air embolism even more difficult in an already sedated patient. Since early recognition increases the chances of patients' survival, endoscopists should be highly motivated and trained to recognize this complication as early as possible. With only 60 cases of air embolism reported (and even fewer related to paradoxical air embolism), we aimed to report a case of paradoxical cerebral air embolism in a patient undergoing ERCP due to a common bile duct stricture and to provide a mini-review of this clinical entity that can serve as a bedside quick reference guide for endoscopists worldwide. S. Karger AG 2021-04-29 /pmc/articles/PMC8138231/ /pubmed/34054400 http://dx.doi.org/10.1159/000514706 Text en Copyright © 2021 by S. Karger AG, Basel https://creativecommons.org/licenses/by-nc/4.0/This article is licensed under the Creative Commons Attribution-NonCommercial-4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission.
spellingShingle Case and Review
Ekmektzoglou, Konstantinos
Alexandrakis, Georgios
Dimopoulos, Konstantinos
Tsibouris, Panagiotis
Kalantzis, Chrysostomos
Vlachou, Erasmia
Apostolopoulos, Periklis
When in Trouble Think of the Bubble: Paradoxical Cerebral Arterial Gas Embolism after Endoscopic Retrograde Cholangiopancreatography
title When in Trouble Think of the Bubble: Paradoxical Cerebral Arterial Gas Embolism after Endoscopic Retrograde Cholangiopancreatography
title_full When in Trouble Think of the Bubble: Paradoxical Cerebral Arterial Gas Embolism after Endoscopic Retrograde Cholangiopancreatography
title_fullStr When in Trouble Think of the Bubble: Paradoxical Cerebral Arterial Gas Embolism after Endoscopic Retrograde Cholangiopancreatography
title_full_unstemmed When in Trouble Think of the Bubble: Paradoxical Cerebral Arterial Gas Embolism after Endoscopic Retrograde Cholangiopancreatography
title_short When in Trouble Think of the Bubble: Paradoxical Cerebral Arterial Gas Embolism after Endoscopic Retrograde Cholangiopancreatography
title_sort when in trouble think of the bubble: paradoxical cerebral arterial gas embolism after endoscopic retrograde cholangiopancreatography
topic Case and Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8138231/
https://www.ncbi.nlm.nih.gov/pubmed/34054400
http://dx.doi.org/10.1159/000514706
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