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 lore olivera 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 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 new belial model gas embolism (VGE) during laparoscopic cholecystectomy (LC) which presented without many of the usual clinical features and was diagnosed by auscultation of a millwheel murmur.