Journal List > Tuberc Respir Dis > v.63(2) > 1001130

TOOLS
Park, Kil, Park, Jeong, Choi, Shin, Lee, Kim, and Choe: A Case of Massive Air Embolism after Contrast-enhanced Computed Tomography
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2007; 63(2): 178-182.

Published online: 31 August 2007

DOI: https://doi.org/10.4046/trd.2007.63.2.178

A Case of Massive Air Embolism after Contrast-enhanced Computed Tomography

Byeong Chool Park, M.D.1, Ho Kil, M.D.1, Chan Sun Park, M.D.1, Jee In Jeong, M.D.1, Eun Young Choi, M.D.1, Yoon Mi Shin, M.D.1, Ki Man Lee, M.D.1, Sung Jin Kim, M.D.2, Kang Hyeon Choe, M.D.1

1Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, Korea.

2Department of Radiology, College of Medicine, Chungbuk National University, Cheongju, Korea.

Address for correspondence: Kang Hyeon Choe, M.D. Department of Internal Medicine, College of Medicine, Chungbuk National University, 12 Gaeshin-dong, Heungduk-gu, Cheongju, Chungbuk, 361-763, Korea. Phone: 82-43-269-6014, Fax: 82-43-273-3252, choekh@chungbuk.ac.kr

Received 14 June 2007       Accepted 11 July 2007

Copyright © 2007 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

A venous air embolism is a complication of various venous access procedures such as contrast-enhanced computed tomography (CECT). Although most cases of iatrogenic venous air embolisms during CECT involve a few milliliters of air and are asymptomatic, a massive venous air embolism can be fatal.
We report a case of a massive intraventricular air embolism after CECT with a review of the literature regarding the pathophysiology and treatment of air embolisms.

Keywords: Air embolism, Contrast-enhanced computed tomography, Complication

Figures and Tables

Figure 1
Simple chest radiograph shows prominent both hili and reticular shadow in both lungs at emergency room.
trd-63-178-g001
Figure 2
Contrast enhanced chest CT scans performed at a local hospital show large amount of air in right ventricle (A) and main pulmonary artery (B). Also, enlargement of both hilar and mediastinal lymph nodes (arrow) are seen (C).
trd-63-178-g002
Figure 3
High resolution CT scans obtained after 8 hours show no air in right ventricle (A) and main pulmonary artery (B).
trd-63-178-g003
Table 1
Caution for injection of contrast media
trd-63-178-i001

References

1. Ie SR, Rozans MH, Szerlip HM. Air embolism after intravenous injection of contrast material. South Med J. 1999. 92:930–933.
2. van Hulst RA, Klein J, Lachmann B. Gas embolism: pathophysiology and treatment. Clin Physiol Funct Imaging. 2003. 23:237–246.
3. Muth CM, Shank ES. Gas embolism. N Engl J Med. 2000. 342:476–482.
4. Sviri S, Woods WP, van Heerden PV. Air embolism: a case series and review. Crit Care Resusc. 2004. 6:271–276.
5. Sakai O, Nakashima N, Shinozaki T, Furuse M. Air bubbles in the subclavian or internal jugular veins: a common finding on contrast-enhanced CT. Neuroradiology. 1998. 40:258–260.
6. Woodring JH, Fried AM. Nonfatal venous air embolism after contrast-enhanced CT. Radiology. 1988. 167:405–407.
7. Price DB, Nardi P, Teitcher J. Venous air embolization as a complication of pressure injection of contrast media: CT findings. J Comput Assist Tomogr. 1987. 11:294–295.
8. Groell R, Schaffler GJ, Rienmueller R, Kern R. Vascular air embolism: location, frequency, and cause on electron-beam CT studies of the chest. Radiology. 1997. 202:459–462.
9. Imai S, Tamada T, Gyoten M, Yamashita T, Kajihara Y. Iatrogenic venous air embolism caused by CT injector: from a risk management point of view. Radiat Med. 2004. 22:269–271.
10. Lee H. Massive intraventricular air embolism after contrast-enhanced CT: report of two cases. J Kor Radiol Soc. 2006. 54:349–352.
11. Vesely TM. Air embolism during insertion of central venous catheters. J Vasc Interv Radiol. 2001. 12:1291–1295.
12. Gottdiener JS, Papademetriou V, Notargiacomo A, Park WY, Cutler DJ. Incidence and cardiac effects of systemic venous air embolism. Echocardiographic evidence of arterial embolization via noncardiac shunt. Arch Intern Med. 1988. 148:795–800.
13. Pham KL, Cohen AJ. Iatrogenic venous air embolism during contrast enhanced computed tomography: a report of two cases. Emerg Radiol. 2003. 10:147–151.
14. Kytta J, Tanskanen P, Randell T. Comparison of the effects of controlled ventilation with 100% oxygen, 50% oxygen in nitrogen, and 50% oxygen in nitrous oxide on responses to venous air embolism in pigs. Br J Anaesth. 1996. 77:658–661.
15. Blanc P, Boussuges A, Henriette K, Sainty JM, Deleflie M. Iatrogenic cerebral air embolism: importance of an early hyperbaric oxygenation. Intensive Care Med. 2002. 28:559–563.
TOOLS
Similar articles