Embolism, Air ; etiology ; Humans ; Intraoperative Complications ; Resuscitation ; Vitrectomy ; adverse effects

Pulmonary barotrauma is a kind of disease caused by the injury of lung tissue or blood vessel when the gas pressure of lung is too high or too lower than the external pressure of the body, which causes the air to enter the blood vessel and adjacent tissue. It could be happened in the escape of the divers with the light diving equipment or the sailors from submarine. Generally, the decompression chamber was used to treating the disease, and the minimum air pressure of 0.5 MPa recompression therapeutic schedule was used to selecting. In November 2019, a patient with pulmonary barotrauma combined with cerebral arterial gas embolism caused by improper underwater escape with light diving equipment was admitted to the General Hospital of Eastern War Zone. He was treated with 0.12 MPa oxygen inhalation recompression scheme in the oxygen chamber pressurized with air. 7 days later, the patient recovered and discharged.
Barotrauma/complications* ; Decompression Sickness/complications* ; Diving/adverse effects* ; Embolism, Air/etiology* ; Humans ; Lung Injury ; Male

Air embolism is a rare complication of percutaneous nephrolithotomy. Patent foramen ovale, which is necessary in fetal circulation, is a potential route for emboli arising from the venous system to enter the systemic arterial circulation, resulting in paradoxical air embolism syndrome. A case of paradoxical air embolism during percutaneous nephrolithotomy is presented. To our knowledge, this is the first report of paradoxical air embolism associated with patent foramen ovale during percutaneous nephrolithotomy.
Adult ; Diverticulum/surgery ; Embolism, Air/*etiology ; Embolism, Paradoxical/*etiology ; Foramen Ovale, Patent/complications/surgery ; Humans ; Intraoperative Complications/*etiology ; Male ; Nephrostomy, Percutaneous/*adverse effects

PURPOSE: Laparoscopic surgery is known to be safe and have low morbidity. Herein, all the complications of retroperitoneal laparoscopic procedures were evaluated. MATERIALS AND METHODS: A total of 120 retroperitoneal laparoscopic surgeries were performed between January 2002 and December 2005. Every abnormal event was investigated retrospectively, and classified in detail according to the surgical steps and severity. RESULTS: The complication ratio (total complications/total surgeries) was 0.38 (46/120). Open conversion was performed in 5 (4.2%). A transfusion was performed in 8 (6.7%) patients. 5 patients (4.2%) had neuromuscular problem related to position and 9 (7.5%) had access and insufflation related complications, including subcutaneous emphysema, abdominal wall hemorrhage, pneumothorax and pneumomediastinum. The intraoperative complications (5.8%) included peritoneal tearing, vascular injury and diaphragmatic injury. Postoperative complications occurred in 25 patients (20.8%), including pleural effusion, atelectasis/pulmonary infiltrate, wound dehiscence, paralytic ileus, retroperitoneal hematoma and urine leakage. 5 complications (4.2%) were classified as being major; main vascular injury (1.7%), urine leakage (1.7%) and diaphragmatic injury (0.8%). No serious complications, such as death, bowel injury, deep vein thrombosis, with pulmonary embolism, or gas embolism occurred. Other complications (41/46) were minor and managed conservatively, without any problem. CONCLUSIONS: The most common complications of retroperitoneal laparoscopic surgery seem to occur during the postoperative period, and are nonspecific to retroperitoneoscopy. Most complications are subclinical problems, which can be managed by conservative treatment. Retroperitoneal laparoscopic surgery is a safe procedure, with a low potential for complications.
Abdominal Wall ; Embolism, Air ; Hematoma ; Hemorrhage ; Humans ; Insufflation ; Intestinal Pseudo-Obstruction ; Intraoperative Complications ; Laparoscopy* ; Mediastinal Emphysema ; Pleural Effusion ; Pneumothorax ; Postoperative Complications ; Postoperative Period ; Pulmonary Embolism ; Retroperitoneal Space ; Retrospective Studies ; Subcutaneous Emphysema ; Vascular System Injuries ; Venous Thrombosis ; Wounds and Injuries

Carbon Dioxide ; adverse effects ; Coronary Artery Bypass ; adverse effects ; Embolism, Air ; complications ; Endoscopy ; Humans ; Male ; Middle Aged ; Saphenous Vein ; transplantation ; Shock ; etiology

Crohn's disease is characterized by its chronic course and transmural inflammation of gastrointestinal tract. The accompanying fibrous reaction and adhesion to adjacent viscera appears to limit the complication of free perforation. The true incidence of free bowel perforation is difficult to assess, however, the anticipated occurrence rate is 1-2% during the course of illness. Moreover, portal venous gas is also an uncommon event in the natural history of Crohn's disease. Portal venous gas occurs when intraluminal gas from the gastrointestinal tract or gas-forming bacteria enters the portal venous circulation. The finding of portal venous gas associated with Crohn's disease does not always mandate surgical intervention. We experienced a case of Crohn's disease presenting with free perforation and portal venous gas. The literatures on the cases with perforation and portal venous gas associated with Crohn's disease were reviewed.
Adult ; Colonoscopy ; Crohn Disease/complications/drug therapy/*pathology ; Diagnosis, Differential ; Embolism, Air/*diagnosis/etiology ; Humans ; Intestinal Perforation/*diagnosis/etiology ; Male ; *Portal Vein ; Tomography, X-Ray Computed

We report a rare case of a massive fatal embolism that occurred in the middle of endoscopic retrograde cholangiopancreatography (ERCP) and retrospectively examine the significant causes of the event. The patient was a 50-year old female with an uncertain history of previous abdominal surgery for multiple biliary stones 20 years prior. The patient presented with acute right upper quadrant pain. An abdominal computed tomographic (CT) scan revealed the presence of multiple stones in the common bile duct (CBD) and intra-hepatic duct (IHD) with biliary obstruction, multifocal liver abscesses, and air-biliarygram. Emergency ERCP showed a wide and straight opening of choledochoduodenostomy, which may have been created during a previous surgery, and multiple filling defects in the CBD. With the use of a forward endoscope, mud stones were extracted through the opening of the choledochoduodenostomy. Cardiac arrest suddenly developed during the procedure, and despite immediate resuscitation, the patient died due to a massive systemic air embolism. We reviewed previously reported fatal cases and accessed factors facilitating air embolisms in this case.
Cholangiopancreatography, Endoscopic Retrograde/*methods ; Choledochostomy/*methods ; Common Bile Duct/radiography ; Embolism, Air/*complications ; Fatal Outcome ; Female ; Humans ; Liver Abscess/pathology ; Middle Aged ; Tomography, X-Ray Computed

Venous air embolism (VAE) is the entrapment of air or medical gases into the venous system causing symptoms and signs of pulmonary vessel obstruction. The incidence of VAE during cesarean delivery ranges from 10 to 97% depending on surgical position or diagnostic tools, with a potential for life-threatening events. We reviewed extensive literatures regarding VAE in detail and herein described VAE during surgery including cesarean delivery from background and history to treatment and prevention. It is intended that present work will improve the understanding of VAE during surgery.
Anesthesia, Obstetrical/adverse effects ; Cesarean Section/*adverse effects ; Echocardiography, Transesophageal/methods ; Embolism, Air/*diagnosis/prevention & control/*ultrasonography ; Female ; Humans ; Intraoperative Complications/ultrasonography ; Monitoring, Intraoperative/methods ; Obstetrics/methods ; Pregnancy ; Risk Factors ; Ultrasonography, Doppler/methods

More than 17 years have elapsed since the introduction of the laparoscopy in the surgical field. The principal characteristics of the laparoscopic surgery that differ from the conventional open surgery are (1) pneumoperitoneum is achieved by the insufflation of CO2 into the abdominal cavity, (2) injury to the abdominal wall is minimized by the use of three to five 5~12 mm trocars, (3) intraabdominal organ and tissue manipulation is reduced and (4) the operative field becomes less dry as the abdominal cavity is not exposed to the room environment. These factors, especially the minimized wound and tissue manipulation, are responsible for the reduced postoperative neuroendocrine and cytokine reactions, decreased pulmonary complications, rapid return of bowel functions, reduced rate of wound complications and the lower incidence of postoperative adhesions. These differences are clinically reflected by a decreased postoperative pain, reduced hospital stay, diminished incidence of postoperative complications and a rapid return to work. To date, laparoscopic surgery is applied to almost all fields of surgery and its indication is expanding everyday. Currently performed laparoscopic procedures include laparoscopic cholecystectomy, laparoscopic appendectomy, diagnostic laparoscopy, laparoscopic herniorrhaphy, laparoscopic fundoplication, laparoscopic Heller myotomy for esophageal achalasia, laparoscopic surgery for solid organs such as the laparoscopic splenectomy and laparoscopic adrenalectomy. Advancements in the laparoscopic instruments and technique have allowed the performance of laparoscopic common bile duct exploration, laparoscopic colonic and gastric resections. Once considered a contraindication due to the risk of air embolism and massive bleeding, laparoscopic hepatic resection is being performed nowadays and reported in the literature. In conclusion, in the near future, with further technological improvement, laparoscopic surgery would almost completely replace the conventional open surgery.
Abdominal Cavity ; Abdominal Wall ; Adrenalectomy ; Appendectomy ; Cholecystectomy, Laparoscopic ; Colon ; Common Bile Duct ; Embolism, Air ; Esophageal Achalasia ; Fundoplication ; Hemorrhage ; Herniorrhaphy ; Incidence ; Insufflation ; Laparoscopy* ; Length of Stay ; Pain, Postoperative ; Pneumoperitoneum ; Postoperative Complications ; Return to Work ; Splenectomy ; Surgical Instruments ; Wounds and Injuries

More than 17 years have elapsed since the introduction of the laparoscopy in the surgical field. The principal characteristics of the laparoscopic surgery that differ from the conventional open surgery are (1) pneumoperitoneum is achieved by the insufflation of CO2 into the abdominal cavity, (2) injury to the abdominal wall is minimized by the use of three to five 5~12 mm trocars, (3) intraabdominal organ and tissue manipulation is reduced and (4) the operative field becomes less dry as the abdominal cavity is not exposed to the room environment. These factors, especially the minimized wound and tissue manipulation, are responsible for the reduced postoperative neuroendocrine and cytokine reactions, decreased pulmonary complications, rapid return of bowel functions, reduced rate of wound complications and the lower incidence of postoperative adhesions. These differences are clinically reflected by a decreased postoperative pain, reduced hospital stay, diminished incidence of postoperative complications and a rapid return to work. To date, laparoscopic surgery is applied to almost all fields of surgery and its indication is expanding everyday. Currently performed laparoscopic procedures include laparoscopic cholecystectomy, laparoscopic appendectomy, diagnostic laparoscopy, laparoscopic herniorrhaphy, laparoscopic fundoplication, laparoscopic Heller myotomy for esophageal achalasia, laparoscopic surgery for solid organs such as the laparoscopic splenectomy and laparoscopic adrenalectomy. Advancements in the laparoscopic instruments and technique have allowed the performance of laparoscopic common bile duct exploration, laparoscopic colonic and gastric resections. Once considered a contraindication due to the risk of air embolism and massive bleeding, laparoscopic hepatic resection is being performed nowadays and reported in the literature. In conclusion, in the near future, with further technological improvement, laparoscopic surgery would almost completely replace the conventional open surgery.
Abdominal Cavity ; Abdominal Wall ; Adrenalectomy ; Appendectomy ; Cholecystectomy, Laparoscopic ; Colon ; Common Bile Duct ; Embolism, Air ; Esophageal Achalasia ; Fundoplication ; Hemorrhage ; Herniorrhaphy ; Incidence ; Insufflation ; Laparoscopy* ; Length of Stay ; Pain, Postoperative ; Pneumoperitoneum ; Postoperative Complications ; Return to Work ; Splenectomy ; Surgical Instruments ; Wounds and Injuries