• A&A practice · Jan 2025

    Case Reports

    Managing Recurrent Carbon Dioxide Embolism During Laparoscopic Hepatectomy With Transesophageal Echocardiography Guidance: A Case Report.

    • Alex Y Pai, Katherine G Rosecrance, Andrew L Ding, Taizoon Q Dhoon, Zelika Jutric, and Govind R Rajan.
    • From the School of Medicine, University of California - Irvine, Irvine, California.
    • A A Pract. 2025 Jan 1; 19 (1): e01909e01909.

    AbstractCarbon dioxide gas emboli is a potentially fatal complication that occurs more frequently during laparoscopic hepatectomy compared to other laparoscopic surgeries. The patient featured in this report had massive gas embolism confirmed by intraoperative transesophageal echocardiography (TEE) that were associated with episodes of severe hypoxemia, hemodynamic instability, and right ventricular failure requiring conversion to open hepatectomy. Abrupt abdominal decompression resulted in massive hemorrhage from a previously undetected defect in the middle hepatic vein. The report demonstrates the successful management of gas embolism during laparoscopic hepatectomy even with a significant delay in vascular repair and highlights the critical role of TEE.Copyright © 2025 International Anesthesia Research Society.

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