{"title":"A case of cerebral infarction caused by carbon dioxide embolism during robotic-assisted laparoscopic partial nephrectomy","authors":"Miho Shiga , Masanobu Shiga , Bunpei Isoda , Satoshi Nitta , Kosuke Kojo , Yoshiyuki Nagumo , Takashi Kawahara , Shuya Kandori , Hiromitsu Negoro , Akio Hoshi , Bryan J. Mathis , Hiroyuki Nishiyama","doi":"10.1016/j.eucr.2025.103016","DOIUrl":null,"url":null,"abstract":"<div><div>Robot-assisted partial nephrectomy (RAPN) is a common, minimally invasive procedure for localized renal tumors but carries a rare risk of life-threatening CO2 embolism. We report an 83-year-old man who developed cerebral embolism from pulmonary CO2 embolism during retroperitoneal RAPN. Intraoperative transesophageal echocardiography (TEE) revealed gas entry into the right heart, a right-to-left shunt, and subsequent gas entry into the left heart system. Postoperatively, MRI confirmed brain infarctions, but the patient was managed conservatively and showed significant recovery. This case demonstrates that maintaining the low pneumoperitoneum pressure, prompt recognition, and appropriate interventions (including TEE and supportive care) may prevent deleterious outcomes.</div></div>","PeriodicalId":38188,"journal":{"name":"Urology Case Reports","volume":"60 ","pages":"Article 103016"},"PeriodicalIF":0.4000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Urology Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2214442025000877","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/3/18 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Robot-assisted partial nephrectomy (RAPN) is a common, minimally invasive procedure for localized renal tumors but carries a rare risk of life-threatening CO2 embolism. We report an 83-year-old man who developed cerebral embolism from pulmonary CO2 embolism during retroperitoneal RAPN. Intraoperative transesophageal echocardiography (TEE) revealed gas entry into the right heart, a right-to-left shunt, and subsequent gas entry into the left heart system. Postoperatively, MRI confirmed brain infarctions, but the patient was managed conservatively and showed significant recovery. This case demonstrates that maintaining the low pneumoperitoneum pressure, prompt recognition, and appropriate interventions (including TEE and supportive care) may prevent deleterious outcomes.
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
