Carbon dioxide embolism during laparoscopic lymph-node biopsy in a girl: A rare occurrence

摘要

Gas embolism is a possible complication during head and neck surgery and laparoscopic procedures. We are presenting our experience of a young girl who underwent a laparoscopic biopsy of the hepatic hilum lymph-nodes for a suspected lymphoma recurrence. Due to her previous clinical history, the patient carried a central venous catheter (CVC). After 20?min from the beginning of the laparoscopic procedure, clinical symptoms were noticed: resuscitation maneuvers were immediately performed and foamy blood was aspirated from the CVC. After the patient was stabilized, the procedure was converted into laparotomy and concluded. Gas embolism is a described complication during laparoscopic procedures, but it is very rare in children where only 5 cases have been described, none registering the death of the patient. Highlights ? Consider air embolism in case of sudden and severe instability during laparoscopy. ? Pediatric anesthetists and surgeons should be aware of this possible complication. ? Early detection with prompt resuscitation can result in a favorable outcome.