Cerebral Air Embolism Following Endoscopic Retrograde Cholangiopancreatography Stent Removal: A Rare and Fatal Complication.
- 1Department of Surgery University of Jaffna Jaffna Sri Lanka jfn.ac.lk.
- 2Teaching Hospital Jaffna Jaffna Sri Lanka thjaffna.lk.
Abstract
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. 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. 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.
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BibTeX
@article{senthuran2026cerebral,
title = {{Cerebral Air Embolism Following Endoscopic Retrograde Cholangiopancreatography Stent Removal: A Rare and Fatal Complication.}},
author = {Bavani Senthuran and A Arulmurali and Anuratha Kajendran and Thishanthini Vijayacumar and Shathana Paramanathan},
journal = {Case reports in anesthesiology},
year = {2026},
month = nov,
doi = {10.1155/cria/6740961},
url = {https://europepmc.org/article/MED/42999672},
note = {CC BY},
}
RIS
TY - JOUR
TI - Cerebral Air Embolism Following Endoscopic Retrograde Cholangiopancreatography Stent Removal: A Rare and Fatal Complication.
AU - Bavani Senthuran
AU - A Arulmurali
AU - Anuratha Kajendran
AU - Thishanthini Vijayacumar
AU - Shathana Paramanathan
PY - 2026
DA - 2026/11/06
JO - Case reports in anesthesiology
DO - 10.1155/cria/6740961
UR - https://europepmc.org/article/MED/42999672
AB - 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. 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. 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.
SN - 2090-6382
SN - 2090-6390
ER -