Document Detail


Gas embolism during hysteroscopy.
MedLine Citation:
PMID:  10232725     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Gas embolism during hysteroscopy is rare but sometimes fatal. A fatal case of gas embolism during diagnostic hysteroscopy using carbon dioxide (CO2) is presented. CLINICAL FEATURES: A 68 yr old woman was admitted for treatment of myoma and cancer of the uterus. Hysteroscopy using CO2 was performed without monitoring or anesthesia on the ward. At the end of the examination, just after the hysteroscope was removed, she developed tonic convulsions, lost consciousness, and her pulse was impalpable. Cardiac massage was started, anesthesiologists were called and the trachea was intubated. She was transferred to the intensive care unit with continuous cardiac massage. Cardiac resuscitation was successful. A central venous line was inserted into the right ventricle under echocardiography in an attempt to aspirate gas with the patient in the Trendelenberg position, but the aspiration failed. Positive end expiratory pressure and heparin for emboli, midazolam for brain protection, and catecholamines were administered. Fifteen hours after resuscitation, the pupils were enlarged and she died 25 hr after resuscitation. CONCLUSION: Gas embolism is a rare complication of hysteroscopy. The procedure should be performed with monitoring of blood pressure, heart rate, oxygen saturation and end-tidal CO2 concentration.
Authors:
T Nishiyama; K Hanaoka
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Canadian journal of anaesthesia = Journal canadien d'anesthésie     Volume:  46     ISSN:  0832-610X     ISO Abbreviation:  Can J Anaesth     Publication Date:  1999 Apr 
Date Detail:
Created Date:  1999-06-18     Completed Date:  1999-06-18     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8701709     Medline TA:  Can J Anaesth     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  379-81     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, The University of Tokyo, Faculty of Medicine, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Anticoagulants / therapeutic use
Carbon Dioxide / adverse effects
Cardiopulmonary Resuscitation
Catheterization, Central Venous
Embolism, Air / etiology*
Epilepsy, Generalized / etiology
Fatal Outcome
Female
Heart Arrest / etiology
Heart Massage
Heparin / therapeutic use
Humans
Hysteroscopy / adverse effects*
Intubation, Intratracheal
Leiomyoma / diagnosis
Midazolam / therapeutic use
Neuroprotective Agents / therapeutic use
Positive-Pressure Respiration
Unconsciousness / etiology
Uterine Neoplasms / diagnosis
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Neuroprotective Agents; 124-38-9/Carbon Dioxide; 59467-70-8/Midazolam; 9005-49-6/Heparin

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