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Case Reports
. 2017 Jul;99(6):e174-e176.
doi: 10.1308/rcsann.2017.0091.

Systemic air embolism as a complication of percutaneous computed tomography guided transthoracic lung biopsy

P Ialongo  1 , L Ciarpaglini  1 , M D Tinti  2   3 , M N Suadoni  3 , G Cardillo  4
Affiliations
Case Reports

Systemic air embolism as a complication of percutaneous computed tomography guided transthoracic lung biopsy

P Ialongo et al. Ann R Coll Surg Engl. 2017 Jul.

Abstract

A 57-year-old man underwent prone position computed tomography (CT) guided percutaneous transthoracic lung biopsy. After removal of the 18-gauge biopsy needle, the patient lost consciousness and developed shock. CT showed signs of air embolism in descending aorta and left atrium. Cardiopulmonary resuscitation was unsuccessful. A postmortem CT scan confirmed a massive air embolism in the descending aorta, left ventricle and brain. Systemic air embolism occurs in around 0.001-0.003% of lung biopsy procedures. Recommendations to reduce the risk include requesting the patient to stop breathing during the procedure and preventing the exposure of the outer cannula of a coaxial biopsy needle to the atmosphere.

Keywords: Embolism; Lung biopsy.

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Figures

Figure 1
Figure 1
Percutaneous computed tomography guided lung biopsy in a patient with multiple pulmonary nodules; the patient is in the prone position.
Figure 2
Figure 2
Radiological evidence of air embolism associated with a minimal pneumothorax.
Figure 3
Figure 3
Post-mortem computed tomography showing a massive air embolism in the left ventricle (supine position).
Figure 4
Figure 4
Post-mortem computed tomography showing a massive air embolism in the descending aorta.
See this image and copyright information in PMC

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