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Medline ® Abstract for Reference 66

of 'Rare complications of endoscopic retrograde cholangiopancreatography (ERCP)'

Cerebral air embolism via port catheter and endoscopic retrograde cholangio-pancreatography.
VachalováI, Ernst S, Vynogradova I, Wöhrmann S, Heckmann JG
Springerplus. 2013;2:477. Epub 2013 Sep 22.
BACKGROUND: Cerebral air embolism (CAE) is a critical clinical condition necessitating rapid diagnosis and therapeutic measures.
METHODS: The authors describe two patients with lethal CAE.
RESULTS: An 81-year-old man rapidly developed coma with tetraplegia. CT-scan revealed prominent CAE whereby the entry of the air was via a port catheter for parenteral nutrition. A 45-year-old man with severe alcohol-toxic multiple organ damage needed endoscopic retrograde cholangio-pancreatography (ERCP) and a second esophagogastroscopy. After an epileptic seizure, the CT-scan of the brain showed small amounts of cerebral air in the posterior right hemisphere and in the sagittal superior sinus. Despite critical care the patient died.
CONCLUSION: CAE is a neurocritical emergency case. Early CT-scan of the brain can detect air, guide further therapy, and contribute to the assessment of the prognosis.
Department of Neurology, Municipal Hospital Landshut, Robert-Koch Str. 1, 84034 Landshut, Germany.