Fatal cerebral air embolism post esophageal endoscopy with dilatation: A case report.

IF 1.5 4区 医学 Q1 LAW
Medicine, Science and the Law Pub Date : 2024-07-01 Epub Date: 2023-11-13 DOI:10.1177/00258024231212878
Kimberly Hamilton, Matthew Orde, Gordon Finlayson
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引用次数: 0

Abstract

This is a case of a patient who underwent an esophageal dilatation for benign esophageal strictures. As a consequence of the procedure, she developed an esophageal rupture and multiple cerebral and cerebellar air emboli resulting in infarction. The patient died after being placed on comfort care measures. The postmortem examination revealed focal breach of the esophageal mucosa but no sites of cardiac or vascular shunting that could account for the transit of air from the esophagus to the central nervous system. The phenomenon of vascular air entry as a consequence of upper gastrointestinal endoscopic intervention is an uncommon but very serious complication of balloon dilatation therapy. Instances of progression to intracranial arterial gas embolism are even less common, but are well described in a small number of case reports. We present a fatal case of central nervous system air embolism post-balloon dilatation therapy with associated antemortem imaging, autopsy, and microscopic images followed by a discussion of potential mechanisms of entry of air into the brain.

食管内镜扩张后致死性脑空气栓塞1例。
这是一例因良性食管狭窄而行食管扩张术的患者。作为手术的结果,她出现了食管破裂和多发性脑和小脑空气栓塞,导致梗死。病人在接受舒适护理措施后死亡。尸检显示食道粘膜局灶性破裂,但没有心脏或血管分流的部位,这可能是空气从食道进入中枢神经系统的原因。由于上消化道内镜介入导致的血管空气进入现象是球囊扩张治疗中一种罕见但非常严重的并发症。进展为颅内动脉气体栓塞的情况更不常见,但在少数病例报告中有很好的描述。我们提出了一个致命的病例中枢神经系统空气栓塞后球囊扩张治疗与相关的临死前成像,尸检和显微图像,随后讨论了空气进入大脑的潜在机制。
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来源期刊
Medicine, Science and the Law
Medicine, Science and the Law 医学-医学:法
CiteScore
2.90
自引率
6.70%
发文量
53
审稿时长
>12 weeks
期刊介绍: Medicine, Science and the Law is the official journal of the British Academy for Forensic Sciences (BAFS). It is a peer reviewed journal dedicated to advancing the knowledge of forensic science and medicine. The journal aims to inform its readers from a broad perspective and demonstrate the interrelated nature and scope of the forensic disciplines. Through a variety of authoritative research articles submitted from across the globe, it covers a range of topical medico-legal issues. The journal keeps its readers informed of developments and trends through reporting, discussing and debating current issues of importance in forensic practice.
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