Carbon Dioxide Embolism During Laparoscopic Right Hepatectomy: A Case Report

Dong-sheng Wu
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Abstract

Complications of laparoscopic surgery include carbon dioxide (CO2) embolism, primarily caused by the entry of CO2 gas into blood vessels or solid organs. If significant clinical symptoms occur, timely intervention is crucial as it can be life-threatening. We report a case of CO2 embolism during laparoscopic right hepatectomy. The patient was a 37-year-old male with no history of liver or kidney dysfunction. During the procedure, there were two episodes of oxygen desaturation (SpO2), and the second episode was accompanied by a significant drop in blood pressure and an increase in heart rate. However, there was no sudden decrease in the end-tidal CO2 partial pressure (ETCO2). Simultaneously, a grinding murmur was auscultated in the precordial area, and foamy blood was aspirated from the right internal jugular vein catheter. This article describes a case of CO2 embolism during laparoscopic surgery and provides a summary of its causes, clinical manifestations, diagnosis, and treatment. It is hoped that this article will contribute to the timely recognition and management of such cases, thereby preventing any potential adverse outcomes for patients.
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腹腔镜右肝切除术中二氧化碳栓塞1例
腹腔镜手术的并发症包括二氧化碳(CO2)栓塞,主要是由二氧化碳气体进入血管或实体器官引起的。如果出现明显的临床症状,及时干预是至关重要的,因为它可能危及生命。我们报告一例CO2栓塞在腹腔镜右肝切除术。患者男性,37岁,无肝肾功能障碍史。在手术过程中,有两次血氧饱和度(SpO2)发作,第二次发作伴有血压明显下降和心率增加。然而,潮末CO2分压(ETCO2)没有突然下降。同时,听诊心前区有磨碎性杂音,并从右颈内静脉导管吸出泡沫性血液。本文描述了一例腹腔镜手术中CO2栓塞的病例,并对其原因、临床表现、诊断和治疗进行了总结。希望本文能对此类病例的及时识别和管理有所帮助,从而防止患者发生任何潜在的不良后果。
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