Air embolism: diagnosis with single-photon emission tomography and successful hyperbaric oxygen therapy.
Venous air embolism may occur when the surgical field is above the level of the heart. We present a case of venous air embolism in a patient undergoing percutaneous nephrolithotripsy in the prone position and presenting with blindness and neurological deficits 8 h later. The clinical diagnosis of paradoxical air embolism was confirmed by early single-photon emission tomography (SPET), whereas magnetic resonance imaging including diffusion-weighted imaging (DW-MRI) was diagnostic only 30 h later. Hyperbaric oxygen therapy was successful. In this case, early DW-MRI scan was inconclusive, but a SPET study of the brain appeared to be useful in confirming the clinical diagnosis. Early hyperbaric oxygen was demonstrated to be a successful therapy.
Droghetti
L
L
Department of Anaesthesia and Intensive Care Medicine, S. Anna Hospital, I-44100 Ferrara, Italy.
Giganti
M
M
Memmo
A
A
Zatelli
R
R
D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging; D004618:Embolism, Air / Q000000981:diagnostic imaging* / Q000628:therapy*; D006801:Humans; D006931:Hyperbaric Oxygenation; D007430:Intraoperative Care / Q000379:methods; D007431:Intraoperative Complications / Q000000981:diagnostic imaging* / Q000628:therapy*; D008096:Lithotripsy; D008279:Magnetic Resonance Imaging; D008297:Male; D009403:Nephrostomy, Percutaneous; D011859:Radiography; D015899:Tomography, Emission-Computed, Single-Photon