Cerebral air embolism is an extremely rare complication of endoscopic procedure and often life threatening. We present two cases of cerebral infarction due to air embolization caused by an endoscopic intervention. The first case occurred during esophageal balloon dilatation for the treatment of a stricture of an anastomosis site in a 59-year-old man and the second case occurred during endoscopic papillary balloon dilatation in a 69-year-old man who had distal common bile duct stones. After the procedure, cardiopulmonary instability and altered mental status were observed in both patients, and cerebral air embolism was diagnosed in both cases. Hyperbaric oxygen therapy was started in the first case, and high FiO2 therapy was applied in the second case. Although this complication is rare, patient outcomes can be improved if physicians are aware of this potential complication, and immediately begin proper management.
Citations
Citations to this article as recorded by
Comparison of the efficacy and safety of endoscopic and fluoroscopic balloon dilatation in benign esophageal strictures Kwangbeom Park, Chang Hoon Oh, Do Hoon Kim, Ji Hoon Shin, Hee Kyong Na, Ji Yong Ahn, Jeong Hoon Lee, Kee Wook Jung, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung The Korean Journal of Internal Medicine.2026; 41(3): 462. CrossRef
Fatal cerebral air embolism post esophageal endoscopy with dilatation: A case report Kimberly Hamilton, Matthew Orde, Gordon Finlayson Medicine, Science and the Law.2024; 64(3): 245. CrossRef
Cerebral air embolism followed by endoscopic balloon dilatation for esophageal strictures Ryoichi Shoji, Naruaki Otake, Takeo Nagura, Jushi Numata, Junya Tsurukiri Acute Medicine & Surgery.2024;[Epub] CrossRef
Diffuse Bi-hemispheric Cortical Infarction Secondary to Cerebral Air Embolism After Elective Esophagogastroduodenoscopy: A Case Report and Review of Literature Rahul Shah, Saumya Shah Cureus.2023;[Epub] CrossRef
When in Trouble Think of the Bubble: Paradoxical Cerebral Arterial Gas Embolism after Endoscopic Retrograde Cholangiopancreatography Konstantinos Ekmektzoglou, Georgios Alexandrakis, Konstantinos Dimopoulos, Panagiotis Tsibouris, Chrysostomos Kalantzis, Erasmia Vlachou, Periklis Apostolopoulos Case Reports in Gastroenterology.2021; 15(1): 456. CrossRef
Massive cerebral air embolism following percutaneous transhepatic biliary drainage Jae Ho Lee, Ha Young Lee, Myung Kwan Lim, Young Hye Kang Medicine.2021; 100(52): e28389. CrossRef
Cerebral Air Embolism after Esophagogastroduodenoscopy: Insight on Pathophysiology, Epidemiology, Prevention and Treatment Malik Ghannam, Azizullah Beran, Dana Ghazaleh, Tanner Ferderer, Brent Berry, Mona Al Banna, Leighton Mohl, Christopher Streib, Tapan Thacker, Ivan Matos Journal of Stroke and Cerebrovascular Diseases.2019; 28(12): 104403. CrossRef
Cerebral air embolism following an endoscopic variceal ligation Xue-song Bai, Bo Yang, Yi-jun Yu, Hong-lan Liu, Zi Yin Medicine.2018; 97(23): e10965. CrossRef
Providing Deep Sedation for Advanced Endoscopic Procedures: The Esthetics of Endoscopic Anesthetics Basavana Goudra, Preet Mohinder Singh Digestive Diseases and Sciences.2016; 61(6): 1426. CrossRef
Fatal Cerebral Air Embolism: A Case Series and Literature Review Rashmi Mishra, Pavithra Reddy, Misbahuddin Khaja Case Reports in Critical Care.2016; 2016: 1. CrossRef
Cerebral Air Embolism Leonardo Pacheco Roquero, Sandra Camelo-Piragua, Carl Schmidt American Journal of Forensic Medicine & Pathology.2016; 37(4): 241. CrossRef