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
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Case Report

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

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


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.


Table 1. Demographic Characteristics, Clinical History, Types of Procedure and Endoscopic Findings of Reviewed Cases
EGD: esophagogastroduodenoscopy; ERCP: endoscopic retrograde cholangiopancreatography; AV: arteriovenous.
Average age64.7
Past medical history
  History of malignancy11
Types of procedure
Use of sedation
Type of gas used in the procedure
Endoscopy findings
  Esophageal bleeding1
  Duodenal AV malformation1
  Calculus in the extrahepatic biliary tree1


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


Table 3. Clinical Signs and Symptoms of Reviewed Cases
Hypoxia with low SpO2
Heart rate
  Loss of consciousness26
    Extremities paralysis7
    Spatial disability1