Korean J Anesthesiol.  2024 Apr;77(2):278-281. 10.4097/kja.23722.

Venous air emboli during esophagoscopy confirmed by computed tomographic pulmonary angiography -a case report-

• Tantisarasart T
• Tantichamnankul T
• Kitsiripant C
• Choochuen P

• KMID: 2553974
• DOI: http://doi.org/10.4097/kja.23722

Abstract

Background
Esophagogastroduodenoscopy (EGD) is vital for the diagnosis and treatment of various gastrointestinal conditions but carries a low risk of venous air embolism (VAE). We report a case of VAE during EGD, confirmed by computed tomographic pulmonary angiography (CTPA). Case: A 56-year-old male with a history of hypopharyngeal cancer underwent EGD for dysphagia-related esophageal dilation. Signs of VAE were noted, prompting swift interventions, including oxygen therapy, positional changes, and CTPA. CTPA revealed the Mercedes-Benz sign, pneumomediastinum, and a minimal pneumothorax. The patient’s oxygen saturation improved within 30 min before undergoing CTPA, and he was discharged on postoperative day 4.
Conclusions
Timely recognition of VAE, resulting in appropriate interventions supported by CTPA, resulted in favorable patient outcomes.

Keyword

Anesthesia; Computed tomographic pulmonary angiography; Esophagogastroduodenoscopy; Hypopharyngeal cancer; Non-operating room anesthesia; Venous air embolism