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Medline ® Abstract for Reference 74

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

Paradoxical air embolus during endoscopic retrograde cholangiopancreatography: an uncommon fatal complication.
Markin NW, Montzingo CR
A A Case Rep. 2015 Apr;4(7):87-90.
Air embolism during endoscopic retrograde cholangiopancreatography is a rare but potentially fatal complication. A 66-year-old man underwent endoscopic retrograde cholangiopancreatography and remained stable until the end of the procedure, when he was found to have mottling on his right side and became hypoxic and unresponsive. Transesophageal echocardiography showed air within the left ventricle, consistent with systemic air embolism. Mortality resulted from significant cardiac and cerebral ischemia. The literature suggests that capnography is helpful in early diagnosis of air embolus, but it could not be used in this case because the patient's trachea was not intubated.
From the Department of Anesthesiology, University of Nebraska Medical Center, Omaha, Nebraska.