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Case Reports
, 5 (2), 35-6

Venous Gas Embolism: An Unusual Complication of Laparoscopic Cholecystectomy

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Case Reports

Venous Gas Embolism: An Unusual Complication of Laparoscopic Cholecystectomy

Tim N Wenham et al. J Minim Access Surg.

Abstract

Venous gas embolism (VGE) is a rare but potentially lethal complication of many forms of surgery, especially posterior fossa neurosurgery where the incidence is reported to be up to 80% - it can also occur in laparoscopic surgery. It usually occurs early in the procedure during insufflation of the abdomen. Rapid entry or large volumes of gas entering the venous circulation initiate a predictable chain of pathophysiological events which may continue to cardiovascular collapse. Arterial hypoxaemia, hypercapnia, decreased end-tidal CO(2), arrhythmias, myocardial ischaemia and elevated central venous and pulmonary arterial pressures can occur. The management of VGE relies on a high index of suspicion and close liaison between anaesthetist, surgeon and theatre staff. The authors present a case of venous gas embolism (VGE) during laparoscopic cholecystectomy (LC) which presented without many of the usual clinical features and was diagnosed by auscultation of a millwheel murmur.

Keywords: CO2 embolism; laparoscopic cholecystectomy; millwheel murmur; venous gas embolism.

Conflict of interest statement

Conflict of Interest: None declared.

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Cited by 3 PubMed Central articles

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