title: [Iatrogenic gas embolism during upper gastroscopy in a patient with a multiperforated biliary drain placed by radiological way].
abstract: The authors report the first case of gas embolism arising during an upper gastrointestinal endoscopy to a patient carrier of a biliary drain placed by radiological way. The hypothesis of a biliary-vascular fistula with abnormal connection between the biliary tree and the hepatic vascular system and finally an arteriovenous intrapulmonary shunt was retained to explain the physiopathology. The immediate stop of the endoscopic procedure and the implementation of symptomatic treatment allowed a favorable neurological outcome without sequelas. The realization of an upper gastrointestinal endoscopy to a patient carrier of a biliary drain has to lead the anaesthesiologists and the gastroenterologists to take care given the incurred risk of gas embolism.
authors: Service d'anesthésie-réanimation, CHU Dupuytren, 2, avenue Martin-Luther-King, 87042 Limoges cedex, France.
authors: L
authors: L
authors: Ramirez
authors: V
authors: V
authors: Hummel
authors: J P
authors: JP
authors: Marsaud
authors: V
authors: V
authors: Valgueblasse
authors: N
authors: N
authors: Nathan
authors: N
authors: N
authors: Pichon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001659:Biliary Tract / Q000000981:diagnostic imaging* / Q000473:pathology*; D001662:Biliary Tract Surgical Procedures / Q000379:methods*; D002763:Cholecystectomy; D004322:Drainage / Q000009:adverse effects*; D017548:Echocardiography, Transesophageal; D004618:Embolism, Air / Q000000981:diagnostic imaging / Q000209:etiology*; D016145:Endoscopy, Digestive System; D005773:Gastroscopy / Q000009:adverse effects*; D006801:Humans; D007049:Iatrogenic Disease; D007431:Intraoperative Complications / Q000209:etiology* / Q000628:therapy*; D008297:Male; D011859:Radiography