scholarly journals Clinical Presentation, Diagnosis, and Management of Air Embolism During Endoscopic Retrograde Cholangiopancreatography

2019 ◽  
Vol 12 (6) ◽  
pp. 283-287
Author(s):  
Muhammad Haisum Maqsood ◽  
Nayab Mirza ◽  
Muhammad Asad Hanif ◽  
Hira Hanif ◽  
Maleeha Saleem ◽  
...  
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Clinical Presentation ◽  
Air Embolism ◽  
Endoscopic Retrograde ◽  
Diagnosis And Management

scholarly journals When in Trouble Think of the Bubble: Paradoxical Cerebral Arterial Gas Embolism after Endoscopic Retrograde Cholangiopancreatography

2021 ◽  
Vol 15 (1) ◽  
pp. 456-469
Author(s):  
Konstantinos Ekmektzoglou ◽  
Georgios Alexandrakis ◽  
Konstantinos Dimopoulos ◽  
Panagiotis Tsibouris ◽  
Chrysostomos Kalantzis ◽  
...  
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Clinical Presentation ◽  
Early Recognition ◽  
Air Embolism ◽  
External Pressure ◽  
Endoscopic Retrograde ◽  
Cerebral Air Embolism ◽  
Reference Guide ◽  
Asymptomatic Patients ◽  
Duct Stricture

Air embolism (a result of direct communication with the vasculature and an external pressure gradient from the gastrointestinal or the biliary tract), although rare, is a potentially devastating adverse event seen in endoscopic retrograde cholangiopancreatography (ERCP) procedures. Whether venous, arterial, or paradoxical, the clinical presentation ranges from asymptomatic patients to cardiorespiratory arrest. This is of particular importance because it makes the diagnosis of air embolism even more difficult in an already sedated patient. Since early recognition increases the chances of patients’ survival, endoscopists should be highly motivated and trained to recognize this complication as early as possible. With only 60 cases of air embolism reported (and even fewer related to paradoxical air embolism), we aimed to report a case of paradoxical cerebral air embolism in a patient undergoing ERCP due to a common bile duct stricture and to provide a mini-review of this clinical entity that can serve as a bedside quick reference guide for endoscopists worldwide.

scholarly journals Endoscopic Retrograde Cholangiopancreatography in Patients With Surgically Altered Gastrointestinal Anatomy: A Retrospective Study

2018 ◽  
Vol 103 (3-4) ◽  
pp. 184-190
Author(s):  
Takaaki Fujimoto ◽  
Yasuhisa Mori ◽  
Yohei Nakashima ◽  
Takao Ohtsuka ◽  
So Nakamura ◽  
...  
Keyword(s):  
Success Rate ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Air Embolism ◽  
Endoscopic Retrograde ◽  
Billroth Ii ◽  
Double Balloon ◽  
Severe Pancreatitis ◽  
Billroth Ii Gastrectomy ◽  
Background Data ◽  
Different Types

Objective: The aim of this study was to evaluate the difficulty of endoscopic retrograde cholangiopancreatography (ERCP) procedures when performed in patients with different types of surgically altered gastrointestinal (GI) anatomies. Summary of background data: Clinical data of 102 consecutive patients with surgically altered GI anatomy who underwent ERCP using a double-balloon enteroscope or a regular gastroendoscope between January 2008 and March 2015 were retrospectively reviewed. Methods: The success rate of reaching the destination, the time until reaching the destination, the success rate of the procedures, and complications were assessed for each type of altered GI anatomy using a double-balloon enteroscope and a regular gastroendoscope. Results: A total of 180 ERCP procedures were performed. The total success rate of reaching the destination was 91% (164 of 180), and that of treatment was 88% (144 of 164). The success rate of reaching the destination in patients with Roux-en-Y hepaticojejunostomy (HJ + R-Y) was significantly lower than that of the other types of reconstruction. The time until reaching the destination was significantly longer in patients after R-Y reconstruction (gastrectomy or HJ) than that after Billroth-II gastrectomy or pancreatoduodenectomy. GI perforation occurred in 2 patients after R-Y reconstruction (1 patient after gastrectomy, and 1 patient after HJ). However, no other complications, such as severe pancreatitis, bleeding, or air embolism, were observed. Conclusions: ERCP for patients with surgically altered GI anatomy is feasible. Improvement of the success rate of reaching the destination in patients after HJ + R-Y and prevention of perforation in those with R-Y reconstruction are necessary.

Fatal air embolism during endoscopic retrograde cholangiopancreatography (ERCP): An ‘impossible’ diagnosis for the forensic pathologist

2015 ◽  
Vol 56 (1) ◽  
pp. 70-73 ◽  
Author(s):  
Matteo Marchesi ◽  
Alessio Battistini ◽  
Moira Pellegrinelli ◽  
Guendalina Gentile ◽  
Riccardo Zoja
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Air Embolism ◽  
Forensic Pathologist ◽  
Endoscopic Retrograde

scholarly journals Diagnosis and Management of Iatrogenic Endoscopic Retrograde Cholangiopancreatography Perforations Based on the European Society of Gastrointestinal Endoscopy Position Statement

2021 ◽  
Vol 96 (4) ◽  
pp. 318-327
Author(s):  
Young Jung Kim ◽  
Chang Hwan Park
Keyword(s):  
Gastrointestinal Tract ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
European Society ◽  
Multidisciplinary Approach ◽  
Gastrointestinal Endoscopy ◽  
Position Statement ◽  
Endoscopic Retrograde ◽  
Diagnosis And Management ◽  
Endoscopic Closure ◽  
Prompt Diagnosis

Endoscopic retrograde cholangiopancreatography (ERCP)-related iatrogenic perforations are identified when gas or luminal contents exit the gastrointestinal tract during ERCP. Although perforations are rare, mortality is high; prompt diagnosis and appropriate management are essential. A multidisciplinary approach is required. The vast majority of such patients can be safely managed medically and endoscopically but must be carefully selected. Endoscopic closure can be considered, depending on the type of perforation. In patients who are deteriorating or whose iatrogenic perforations are not securely closed endoscopically, surgery is mandatory.

scholarly journals Two Cases of Cerebral Air Embolism That Occurred during Esophageal Ballooning and Endoscopic Retrograde Cholangiopancreatography

2016 ◽  
Vol 49 (2) ◽  
pp. 191-196 ◽  
Author(s):  
Suyeon Park ◽  
Ji Yong Ahn ◽  
Young Eun Ahn ◽  
Sang-Beom Jeon ◽  
Sang Soo Lee ◽  
...  
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Air Embolism ◽  
Endoscopic Retrograde ◽  
Cerebral Air Embolism
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