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Case Reports
. 2021 Oct 27;2021(10):rjab448.
doi: 10.1093/jscr/rjab448. eCollection 2021 Oct.

Needle insufflation into the liver as a cause of massive gas embolus and CVA

Pamela G McIntosh  1 , Chris G Andrew  1
Affiliations
Case Reports

Needle insufflation into the liver as a cause of massive gas embolus and CVA

Pamela G McIntosh et al. J Surg Case Rep. .

Abstract

Laparoscopy is being applied more frequently and in broader applications. Complications of this technique are infrequent, and rare among them are gas emboli due to insufflation. This paper describes a 65-year-old obese female presenting for elective laparoscopic cholecystectomy who suffered a cerebral vascular accident after Veress needle insertion into undiagnosed severe fatty liver led to a massive gas embolus. Our patient experienced immediate cardiac compromise and acute monoparesis. Intra-operative transesophageal echocardiogram revealed copious air in the right atria and ventricle. A needle track within the liver was visible on a post-operative computerized tomography scan. The patient made a full recovery, but this acts as a reminder to be vigilant for potential complications of laparoscopy and highlights challenges of laparoscopic entry in the severely obese.

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Figures

Figure 1
Figure 1
CT thorax and abdomen, infused, immediately post-operative noting severe fatty infiltration within the liver and Veress needle track.
See this image and copyright information in PMC

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