Carbon dioxide embolism in a 3-week-old neonate during laparoscopic pyloromyotomy: a case report

Gas embolus and cardiac arrest during laparoscopic pyloromyotomy in an infant

“…Most cases are diagnosed by auscultative or hemodynamic changes and loss of end-tidal CO 2 , followed by successful resuscitation efforts. 1,2,4 Management includes removal of the carbon dioxide source, intravascular volume replacement, inotropic support, and if necessary, chest compressions. Hyperbaric oxygen therapy may be required if there is persistent evidence of gas hours following an embolic event.…”

“…Historically, circulatory collapse associated with laparoscopic insufflation has been attributed to carbon dioxide embolism, [1][2][3][4] but the severity of some events is not consistent with intravenous carbon dioxide alone, and nitrogen in air may contribute to sustained hemodynamic decompensation and catastrophic outcomes. We report the case of a 12-day-old infant who suffered a massive embolism during laparoscopic pyloromyotomy, cardiac arrest, and successful resuscitation that included hyperbaric oxygen therapy for documented intracranial arterial gas emboli.…”

Severe carbon dioxide embolism during laparoscopic kidney resection

“…The incidence of clinically significant CO 2 embolism during laparoscopy is rare and its severity depends on the rate and volume of gas entry 1,2 . Durant's position allowed the gas bubble to migrate toward the apex of the heart and away from the pulmonary artery, 2,3 which contributed to the discrepancy of severe CO 2 embolism with few significant signs in this patient. This case report also suggested that BP, HR, SpO 2 and P ET CO 2 are not sensitive surrogates in detecting CO 2 embolism in some cases.…”

Letter to the Editor

“…To the Editor, We read with interest the article by Bergholz and Wenke [1] on enterolithiasis in the neonatal period recently published in the April 2009 issue of the journal. The authors described apparent intraluminal calcification of meconium in a baby with an anorectal malformation and a rectourethral fistula.…”