Work

Cerebral Air Embolism Following Endoscopic Retrograde Cholangiopancreatography Stent Removal: A Rare and Fatal Complication

Year: 2026

Type: article

Abstract: Background: Endoscopic retrograde cholangiopancreatography (ERCP) is a generally performed procedure for biliary pathology. Although usually safe, air embolism is an exceptionally rare but potentially fatal complication. Case Presentation: We report the case of a 79-year-old female (ASA II) with a history of dyslipidemia and obesity, who presented for elective ERCP and biliary stent removal. She had previously undergone ERCP and open cholecystectomy for choledocholithiasis. During this time, sedation was administered by using fentanyl, midazolam, and propofol via target-controlled infusion. The procedure was initially uneventful; however, at its conclusion, the patient developed sudden desaturation, bradycardia, and a reduced level of consciousness. Computed tomography (CT) imaging revealed multiple cerebral air emboli. Despite intensive care management and ventilatory support, the patient deteriorated and died 2 days later. Conclusion: This case highlights the importance of maintaining vigilance for air embolism, even in seemingly straightforward ERCP procedures, especially in elderly patients. Early recognition and immediate management are vital to improving outcomes.

Source: Case Reports in Anesthesiology

DOI: 10.1155/cria/6740961

Authors: Bavani Senthuran, A. Arulmurali, Anuratha Kajendran, Thishanthini Vijayacumar, Shathana Paramanathan

Institutions: University of Jaffna, Jaffna Teaching Hospital

Language: English

Topic: Gallbladder and Bile Duct Disorders

Subfield: Gastroenterology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $790