# Air embolism complicating endoscopic retrograde cholangiopancreatography

## TL;DR

This case report describes a life-threatening air embolism during a common endoscopic procedure and emphasizes the importance of early detection and treatment.

## Contribution

The paper highlights the critical role of awareness and early diagnosis in managing air embolism during endoscopic retrograde cholangiopancreatography.

## Key findings

- Venous air embolism can cause cardiovascular collapse during endoscopic retrograde cholangiopancreatography.
- Early echocardiography and aspiration of air bubbles can save the patient's life.
- Prompt recognition by endoscopists and anesthetists is essential for effective treatment.

## Abstract

Aim: Venous air embolism is a rare but potentially life threatening complication of endoscopic retrograde cholangiopancreatography. Diagnosis is difficult because of the lack of specific signs or symptoms. Case: A 62-year-old man underwent endoscopic retrograde cholangiopancreatography for choledocholithiasis. A cardiovascular collapse occurred during the procedure. The echocardiography showed air within the right ventricle. Aspiration of air from the right ventricle was done and saved the patient's life. Conclusion: We highlight through this case that increased awareness is essential for prompt recognition of the air embolism to allow life-saving therapy.

Endoscopic treatment is the first-line treatment for biliary stones. It may be associated with various complications. We report the case of a 62-year-old patient who underwent endoscopic treatment for biliary stone. During the procedure, he experienced disturbed cardiac function due to the passage of air bubbles into the cardiac cavities. The bubbles were aspirated with a good outcome.

Venous air embolism is a rare complication of endoscopic retrograde cholangiopancreatography.

The diagnosis must be suspected in the presence of unexplained cardiovascular and respiratory signs with a sudden onset.

The diagnosis is based on an early cardiac ultrasound.

Early aspiration of cardiac air bubbles often saves the patient's life.

Aspiration of cardiac air bubbles saves patient's life early cardiac ultrasound.

This case report highlights the importance of endoscopist and anesthetist awareness, which allows for prompt recognition of air embolism and early therapy administration.