Skip to main content
SpringerLink
Log in

Iatrogenic venous air embolism during contrast enhanced computed tomography: a report of two cases

  • Case Report
  • Published:
Emergency Radiology Aims and scope Submit manuscript

Abstract.

Venous air embolism (VAE) is a known complication of venous access procedures such as contrast-enhanced computed tomography (CECT). Although a massive VAE can be fatal, most iatrogenic VAE cases during CECT involve a few milliliters of air and are asymptomatic. We report two cases of massive and nonfatal VAE during CECT. Both cases involve the inadvertent injection of air instead of contrast by power injectors during the contrast phase. In both cases, the patients were stable and survived the event without permanent sequelae. We also discuss the pathophysiology, treatment, and prevention of VAE, especially during CECT.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1a–c.
Fig. 2a–c.

Similar content being viewed by others

References

  1. Yeakel AE (1968) Lethal air embolism from plastic blood-storage container. JAMA 204:267–269

    Article  CAS  PubMed  Google Scholar 

  2. Toung TJ, Rossberg, MI, Hutchins GM (2001) Volume of air in a lethal venous air embolism. Anesthesiology 94: 360–361

    CAS  PubMed  Google Scholar 

  3. 3 Woodring JH, Fried AM (1988) Nonfatal venous air embolism after contrast enhanced CT. Radiology 167:405–407

    CAS  PubMed  Google Scholar 

  4. Groell R, Schaffler GJ, Rienmueller R, Kern R (1997) Vascular air embolism: location, frequency, and cause on electron–beam CT studies of the chest. Radiology 202:459–462

    CAS  PubMed  Google Scholar 

  5. Ie SR, Rozans MH, Szerlip HM (1999) Air embolism after intravenous injection of contrast material. South Med J 92:930–933

    CAS  PubMed  Google Scholar 

  6. Mammoto T, Hayashi Y, Ohnishi Y, et al (1998) Incidence of venous and paradoxical air embolism in neurosurgical patients in the sitting position: detection by transesophageal echocardiography. Acta Anaesthesiol Scand 42:643–647

    CAS  PubMed  Google Scholar 

  7. Corson SL, Brooks PG, Soderstrom RM (1996) Gynecologic endoscopic gas embolism. Fertil Steril 65:529–533

    Google Scholar 

  8. Hill BF, Jones JS (1993) Venous air embolism following orogenital sex during pregnancy. Am J Emerg Med 11:155–157

    CAS  PubMed  Google Scholar 

  9. Marc B, Chadly A, Drigon M (1990) Fatal air embolism during female autoerotic practice. Int J Legal Med 104:59–61

    CAS  PubMed  Google Scholar 

  10. Lee SY, Choi BIW, Kim, JS, Park KS (2002) Paradoxical air embolism during hepatic resection. Br J Anaesth 88:136–138

    Article  CAS  PubMed  Google Scholar 

  11. Vesely TM (2001) Air embolism during insertion of central venous catheters. J Vasc Interv Radiol 12:1291–1295

    CAS  PubMed  Google Scholar 

  12. Kizer KE, Goodman PC (1982) Radiographic manifestations of venous air embolism. Radiology 144:35–39

    CAS  PubMed  Google Scholar 

  13. Geissler HJ, Allen SJ, Mehlhorn U, Davis K, Morris WP, Butler BD (1997) Effect of body repositioning after venous air embolism. Anesthesiology 86:710–717

    CAS  PubMed  Google Scholar 

  14. Rossi SE, Goodman PC, Franquet T (2000) Nonthrombotic pulmonary emboli. AJR Am J Roentgenol 174:1499–1508

    CAS  PubMed  Google Scholar 

  15. Berthelot P, Walker JG, Sherlock S, Reid L (1966) Arterial changes in the lungs in cirrhosis of the liver. Lung spider nevi. N Engl J Med 274:291–298

    CAS  PubMed  Google Scholar 

  16. Rubinstein D, Dangleis K, Damiano TR (1996) Venous air emboli identified on head and neck CT scans. J Comput Assist Tomogr 20:559–562

    Article  CAS  PubMed  Google Scholar 

  17. Durant TM, Long J Oppenheimer J (1947) Pulmonary (venous) air embolism. Am Heart J 33:269–281

    Google Scholar 

  18. IE SR, Rozans MH, Szerlip HM (1999) Air embolism after intravenous injection of contrast material. South Med J 92:930–933

    CAS  PubMed  Google Scholar 

  19. Blanc P, Boussuges A, Henriette K, Sainty JM, Delflie M (2002) Iatrogenic cerebral air embolism: importance of an early hyperbaric oxygenation. Intensive Care Med 28:559–563

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medical Education, Building 22A, Rm 2108, 101 City Drive South, Orange, CA 92868, USA

    Keith L. Pham

  2. Department of Radiological Sciences, TRLR 11 – RT 140, University of California, Irvine–Medical Center, Orange, CA 92868, 101 City Drive South, USA

    Allen J. Cohen

Authors
  1. Keith L. Pham
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Allen J. Cohen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Keith L. Pham.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pham, K.L., Cohen, A.J. Iatrogenic venous air embolism during contrast enhanced computed tomography: a report of two cases. Emergency Radiology 10, 147–151 (2003). https://doi.org/10.1007/s10140-003-0270-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10140-003-0270-y

Keywords

Search

Navigation