Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc
Journal website https://www.journalmc.org

Case Report

Volume 12, Number 3, March 2021, pages 119-125

Cerebral Air Embolism After Gastrointestinal Procedure: A Case Report and Literature Review

Figures

Figure 1.
Figure 1. Endoscopy which showed esophageal ring (red arrows) in the proximal esophagus, 15 cm from the incisors.
Figure 2.
Figure 2. Computed tomography of head showing multiple foci of intraparenchymal air (red arrows) suggestive of air emboli.
Figure 3.
Figure 3. Computed tomography angiogram of the head and neck showing occlusion of the intracranial carotid arteries (red arrows), mid and distal cervical internal carotid arteries, anterior and middle cerebral arteries, and distal posterior cerebral artery branches.
Figure 4.
Figure 4. PRISMA flow chart of study selection.

Tables

Table 1. Demographic Characteristics, Clinical History, Types of Procedure and Endoscopic Findings of Reviewed Cases
 
EGD: esophagogastroduodenoscopy; ERCP: endoscopic retrograde cholangiopancreatography; AV: arteriovenous.
N26
Average age64.7
Gender
  Male16
  Female10
Past medical history
  History of malignancy11
  Unknown10
Types of procedure
  EGD13
  ERCP13
Use of sedation
  Yes15
  No2
  Unknown9
Type of gas used in the procedure
  Air2
  CO20
  Unknown24
Endoscopy findings
  Stricture14
  Diverticulum1
  Varices2
  Esophageal bleeding1
  Esophagitis/gastritis3
  Duodenal AV malformation1
  Calculus in the extrahepatic biliary tree1
  Unknown4

 

Table 2. Imaging Findings of the Reviewed Cases
 
CT: computed tomography.
N26
CT findings
  Positive findings of air in brain parenchymal or pneumocephalus or presence of air in the cerebral artery23
  Unknown3
Echocardiogram findings
  Presence of right to left shunt9
  No right to left shunt6
  Unknown11

 

Table 3. Clinical Signs and Symptoms of Reviewed Cases
 
N26
Hypoxia with low SpO2
  Yes26
  No0
Heart rate
  Bradycardia26
  Tachycardia0
  Normal0
Mentation
  Loss of consciousness26
  Awake0
  Confused0
Outcome
  Alive10
    Extremities paralysis7
    Spatial disability1
    Normal2
  Expired14
  Unknown2