title: Fatal cerebral air embolism following endoscopic evaluation of rectal stump.
abstract: A 63-year-old man underwent endoscopic evaluation of the rectal stump for rectal bleeding and suffered a massive cerebral air embolism with severe neurological impairment and subsequent death. The patient underwent a Hartmann's procedure 9 month previously for ischaemic bowel and was noted to have portal hypertension at laparotomy. We hypothesise that air entered the venous plexus around rectum and entered the azygos vein via a porto-systemic shunt and travelled retrogradely via the superior vena cava to the venous sinuses of the brain.
authors.affiliation: Department of Surgery, South Infirmary Victoria University Hospital, Cork, Ireland.
authors.forename: Chwanrow Karim
authors.initials: CK
authors.lastname: Baban
authors.forename: Michael
authors.initials: M
authors.lastname: Murphy
authors.forename: Tony
authors.initials: T
authors.lastname: Hennessy
authors.forename: Deirdre
authors.initials: D
authors.lastname: O'Hanlon
mesh_terms: D000388:Air; D004618:Embolism, Air / Q000209:etiology*; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects*; D017809:Fatal Outcome; D006471:Gastrointestinal Hemorrhage / Q000601:surgery*; D006801:Humans; D007410:Intestinal Diseases / Q000601:surgery; D020766:Intracranial Embolism / Q000209:etiology*; D007511:Ischemia / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012007:Rectum / Q000601:surgery*; D014683:Vena Cava, Superior / Q000473:pathology*