Although venous air embolism is a known complication in medical practice in general, only a single case of upper gastrointestinal endoscopy complicated by venous air embolism with consecutive acute cardiovascular failure has so far been described in literature. Here we show that gastroscopy may be accompanied by massive, i.e. fatal venous air embolism. If a vessel in the gastrointestinal tract is exposed but does not collapse (in the case of a gastric ulcer, for example) air insufflated under pressure by the gastroscope may lead to a fatal air embolism. Our tests using a commercial gastroscope revealed that an overpressure of up to 43 kPa (kiloPascals) is reached without the rinsing function while an overpressure of up to 45 kPa is measured if the rinsing function is operated simultaneously. The maximum flow rates without resistance were 100 ml/min for rinsing liquid (purified water) and 2000 ml/min for air. Our results suggest that air insufflation by the gastroscope may result in a critical air embolism within very few seconds on condition that a connection with the vascular system exists. However, this complication is extremely rarely encountered. We propose that CO2 should be administered in place of air or alternatively the maximum pressure should be considerably reduced to avoid a fatal outcome in routinely performed gastroscopical examinations.

The spectral transmissions of cornea, aqueous humour, lens and vitreous humour of human eyes were measured in the range from 250 nm to 800 nm in 1 nm steps using a high resolution double monochromator. Cornea and lens are good cut off filters; 1% transmission was measured in various cornea samples between 291 and 298 nm, and in different lenses between 389 and 414 nm. Aqueous humour and vitreous humour showed high transparency (80%) at lambda > 320 nm. The wavelength range of keratitis effective irradiance was found to be completely within the wavelength range of absorption of the cornea, that of cataract effective irradiance was found to be at the short wavelength end partly outside the wavelength range of absorption of the lens. It may therefore be supposed that the action spectrum of cataract obtained by animal experiments is applicable to the human eye only with certain reservations.

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