Venous gas embolism: An unusual complication of laparoscopic cholecystectomy

Venous gas embolism: An unusual complication of laparoscopic cholecystectomy

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Venous gas embolism (VGE) is a rare but potentially lethal complication of many forms of surgery, especially posterior fossa neurosurgery where the incidence is reported to be up to 80% - it can also occur in laparoscopic surgery.It usually occurs early in the procedure during kaiser copy stands insufflation of the abdomen.Rapid entry or large volumes of gas entering the venous circulation initiate a predictable chain of pathophysiological events which may continue to cardiovascular collapse.Arterial hypoxaemia, hypercapnia, decreased end-tidal CO 2 , arrhythmias, myocardial ischaemia and elevated central venous and pulmonary arterial pressures can occur.The management of VGE relies on a high index of suspicion and close liaison between anaesthetist, surgeon and theatre staff.

The authors present a case of venous gas embolism (VGE) during laparoscopic cholecystectomy (LC) which presented without many of the usual nordic forge rounding hammer clinical features and was diagnosed by auscultation of a millwheel murmur.