Successful resuscitation after carbon dioxide embolism during laparoscopic-assisted abdomino-perineal resection

We report a 67-year-old woman who underwent laparoscopic-assisted abdomino-perineal resection for rectal carcinoma. She sustained hypotension of 40/20 mmHg associated with bradycardia (heart rate 30 to 45 beats per minute) and an end-tidal carbon dioxide level of zero when she was raised to a head-up position at the end of surgery to facilitate pelvic irrigation. Pulmonary air embolism was confirmed by aspiration of 15 millilitres of foamy blood from her central venous line. Resuscitation was successful and she recovered completely with no neurological deficits.