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Case Reports
. 2012 Dec;14(12):871-3.
doi: 10.1111/j.1477-2574.2012.00550.x. Epub 2012 Aug 30.

Successful management of a large air embolus during an extended right hepatectomy with an emergency cardiopulmonary bypass

Elizabeth Foo  1 , Duncan Williams, Harsh Singh, Paul G Bridgman, John McCall, Saxon Connor
Affiliations
Case Reports

Successful management of a large air embolus during an extended right hepatectomy with an emergency cardiopulmonary bypass

Elizabeth Foo et al. HPB (Oxford). 2012 Dec.

Abstract

Background: An air embolus is a recognized but rare complication of a partial hepatectomy. The aim of this report was to describe the diagnosis and management of a large paradoxical air embolus during hepatic resection.

Methods: Case report.

Results: A single patient report of a massive paradoxical air embolus during an extended right hepatectomy is described. The diagnosis was confirmed by trans-oesophageal echo (video provided). After failed conservative management an emergency cardiopulmonary bypass was instituted with a successful outcome.

Conclusion: Surgeons and anaesthetists involved in hepatic surgery should be aware of signs, investigations and management of this life-threatening intra-operative complication.

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Figures

Figure 1
Figure 1
Magnetic resonance imaging (MRI) showing a tumour replacing the right lobe of the liver and compressing the inferior vena cava (IVC). The tumour can be seen compressing the origin of the middle hepatic vein (MHV) and the left hepatic vein (LHV)
See this image and copyright information in PMC

References

    1. Hatano Y, Murakawa M, Segewa H, Nishida Y, Mori K. Venous air embolism during hepatic resection. Anesthesia. 1990;73:1282–1285. - PubMed
    1. Mirski MA, Vijay Lele A, Fitzsimmons L, Toung TJK. Diagnosis and treatment of vascular air embolism. Anesthesia. 2007;106:164–177. - PubMed
    1. Thiery G, Le Corre F, Sauvanett A, Belghiti J, Marty J. Paradoxical air embolism during orthoptic liver transplantation:diagnosis by transoesophageal echocardiography. Eur J Anaesth. 1999;16:342–345. - PubMed
    1. Lee SY, Choi BIW, Kim JS, Park KS. Paradoxical air embolism during hepatic resection. Br J Aaesth. 2002;88:136–138. - PubMed
    1. Rademaker BMP, Groenman FA, Van der Wouw PA, Bakkum EA. Paradoxical gas embolism by transpulmonary passage of venous emboli during hysteroscopic surgery: a case report and discussion. Br J Anaesth. 2008;101:230–233. - PubMed