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BJA Advance Access published online on June 3, 2008
British Journal of Anaesthesia, doi:10.1093/bja/aen138
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2008. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Paradoxical gas embolism by transpulmonary passage of venous emboli during hysteroscopic surgery: a case report and discussion

B. M. P. Rademaker1,*, F. A. Groenman2, P. A. van der Wouw3 and E. A. Bakkum2

1 Department of Anaesthesiology,
2 Department of Obstetrics and Gynaecology and
3 Department of Cardiology, Onze Lieve Vrouwe Gasthuis, Oosterpark 9, 1091 AC Amsterdam, The Netherlands

* Corresponding author. E-mail: b.m.p.rademaker{at}olvg.nl

After an episode of apparent venous gas embolism in a patient undergoing surgical hysteroscopy, transoesophageal echocardiography revealed air in the left but not in the right heart. Contrast echocardiography failed to demonstrate anatomical right-to-left shunts, making it likely that venous emboli overwhelmed the capacity of lungs to filter emboli, resulting in paradoxical embolization.

Keywords: complications, embolism; endoscopy; surgery, gynaecology


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This article has been cited by other articles:


Home page
 Br J AnaesthHome page
S. Sherlock and B. M. P. Rademaker
Paradoxical gas embolism during hysteroscopy
Br. J. Anaesth., November 1, 2008; 101(5): 742 - 743.
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Paradoxical gas embolism during hysteroscopy
Susannah D Sherlock
British Journal of Anaesthesia, 20 Jul 2008 [Full text]
Paradoxical gas embolism during hysteroscopy
Bart M Rademaker
British Journal of Anaesthesia, 11 Aug 2008 [Full text]

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