Massive venous air embolism in a case of hysteroscopy: A rare grave complication in a comparatively simple procedure

Abstract

Hysteroscopic surgery has gained popularity but lethal complication like gas or venous air embolism can occur. It can be recognized by a decrease in oxygen saturation and sudden drop in end-tidal carbon dioxide and may sometimes lead to severe organ failure and death depending on the amount of air embolism. We report the case of a 55-year-old female with no comorbidities posted for evaluation of postmenopausal bleeding by diagnostic hysteroscopy. The procedure was performed under spinal anesthesia using normal saline as distending media. Midway between the procedures, the patient developed severe bradycardia and desaturation. Hence, with the diagnosis of massive pulmonary embolism, the patient was resuscitated but could not be revived. The fatal outcome from a comparatively simple procedure is not uncommon. Complications are to be kept in mind and possible precautionary measures are to be taken at all times. As the eye cannot see what the mind does not know.