Sudden Death After Endoscopic Retrograde Cholangiopancreatography (ERCP)—Case Report and Literature Review

Hauser, Goran; Milošević, Marko; Zelić, Marko; Stimac, Davor

doi:10.1097/md.0000000000000235

Cited by 12 publications

(12 citation statements)

References 21 publications

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“…[ 4 , 5 ] Symptoms range in severity from dyspnea to cardiac arrest, and mortality rate may be up to 50%. [ 6 , 7 ] Prompt detection of VAE by transesophageal echocardiography (TEE) is crucial for effective therapy. [ 8 – 10 ] We describe a case of fatal VAE that caused repeated cardiac arrest during hepatic resection and was confirmed by TEE.…”

Section: Introductionmentioning

confidence: 99%

Repeated cardiac arrest caused by an air embolism during hepatic resection

Luo

Peng²,

Zhu³

et al. 2018

Medicine

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Rationale:Although venous air embolism (VAE) during liver operation has been reported occasionally, fatal VAE in hepatic resection is uncommon. Prompt detection of VAE by transesophageal echocardiography (TEE) is crucial for effective therapy. We describe a case of fatal VAE that caused repeated cardiac arrest during hepatic resection and was confirmed by TEE.Patient concerns:A 51-year-old woman with a body weight of 50 kg underwent partial liver resection due to intrahepatic duct calculus. She had a 1-year history of intrahepatic duct calculus without cardiopulmonary disease. The operation was performed under general anesthesia combined with epidural block. When the inferior vena cava was compressed, the PetCO2 level decreased abruptly from 30 to 10 mmHg, followed by a decrease in SpO2 and the development of hypotension. Her heart rate increased with ST interval elevation on electrocardiography monitoring. Ephedrine and phenylephrine were administered immediately but had little effect. Cardiac arrest occurred.Diagnoses:Air embolism was detected by TEE.Interventions:Resuscitation was successful although cardiac arrest occurred repeatedly.Outcomes:The patient returned to consciousness 6 hours postoperatively but died of multiorgan dysfunction 10 days later.Lessons:Fatal air embolism may happen during hepatic resection. Prompt detection of VAE by TEE is crucial for effective therapy and should always be available during hepatic resection.

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Section: Introductionmentioning

confidence: 99%

Repeated cardiac arrest caused by an air embolism during hepatic resection

Luo

Peng²,

Zhu³

et al. 2018

Medicine

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“…Hyperbaric oxygen therapy is a method of choice but is not available in all places [9]. Differential diagnoses to be considered during air embolism are acute coronary syndrome, pulmonary embolism, and cardiogenic shock [10].…”

Section: Discussionmentioning

confidence: 99%

“…Later, the patient was recovered [4]. Hauser et al described another case of sudden death following ERCP in a patient of non-Hodgkin lymphoma with cholestatic jaundice due to gall stones [10]. Lanke and Adler identified 51 cases of air embolism following ERCP, which includes systemic air embolism, venous air embolism, and cerebral air embolism.…”

Section: Discussionmentioning

confidence: 99%

A Dreaded Procedural Complication During Endoscopic Retrograde Cholangiopancreatography

Ramdas¹,

Pallivalappil²,

Jithin³

et al. 2020

IJCR

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“…The adverse events of ERCP are well documented, while in rare occasions fatal adverse events may occur . Therefore, in order to make rational decisions patients need to be fully informed.…”

Section: Discussionmentioning

confidence: 99%

Video education can improve awareness of risks for patients undergoing endoscopic retrograde cholangiopancreatography: A randomized trial

Xia

Zhu

Zeng

et al. 2019

J of Digest Diseases

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Objective: We conducted a randomized trial aiming at improving patients' informed consent for undergoing endoscopic retrograde cholangiopancreatography (ERCP) in clinical care by comparing the efficacy of an additional educational video to written informed consent with that of written informed consent alone.Methods: This was a single-center, randomized controlled trial. Consecutive patients undergoing ERCP were randomized to a video education or a control group. An educational video detailing ERCP procedure plus standard written informed consent was administered to the video education group, while the control group reviewed standard written informed consent only. The primary outcome was the patients' perception of the risk or possibility of ERCP complications. Their perception of the benefits of ERCP, alternative treatments and overall satisfaction with the process of informed consent were also compared. Results:In total 205 patients were included in the study (104 in the control group and 101 in the video education group). Patients' comprehension of ERCP-related complications in the video education group was significantly increased (P < 0.001), and these patients were more likely to correctly identify the incidence of such complications. Significantly more patients in the video education group were very satisfied with informed consent process (87.1% vs 76.0%, P = 0.040) and fewer patients needed additional explanations (31.7% vs 47.1%, P = 0.024).Conclusions: A supplementary educational video could greatly improve patient's understanding of ERCP procedure, in particular, its potential risks and complications, as well as their overall satisfaction with the process of informed consent (ClinicalTrials.gov no. NCT02810379). K E Y W O R D Seducation, endoscopic retrograde cholangiopancreatography, informed consent, video † These authors contributed equally to this work.

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Sudden Death After Endoscopic Retrograde Cholangiopancreatography (ERCP)—Case Report and Literature Review

Cited by 12 publications

References 21 publications

Repeated cardiac arrest caused by an air embolism during hepatic resection

Repeated cardiac arrest caused by an air embolism during hepatic resection

A Dreaded Procedural Complication During Endoscopic Retrograde Cholangiopancreatography

Video education can improve awareness of risks for patients undergoing endoscopic retrograde cholangiopancreatography: A randomized trial

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