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Endoscopic Studies II: Thoracocentesis

Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
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Clinical Manifestations:
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Induction of Cerebral Arterial Gas Embolism in Rat
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Nonfatal air embolism during shoulder arthroscopy.

Vivek Pandey1, Elsa Varghese, Madhu Rao

  • 1Department of Orthopaedics, Kasturba Medical College, Manipal, Karnataka, India. vivekortho@gmail.com

American Journal of Orthopedics (Belle Mead, N.J.)
|June 28, 2013
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Summary

Air embolism is a rare complication of shoulder arthroscopy. Monitoring end-tidal carbon dioxide aids early detection during procedures for acute shoulder fractures.

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Area of Science:

  • Orthopedic Surgery
  • Vascular Surgery
  • Anesthesiology

Background:

  • Shoulder arthroscopy is a common procedure for shoulder injuries.
  • Air embolism is a rare but serious complication.
  • Acute bony Bankart lesions and greater tuberosity avulsions often require arthroscopic intervention.

Observation:

  • A patient developed a venous air embolism during shoulder arthroscopy for acute fractures.
  • The event occurred immediately after joint insufflation with air.
  • Diagnosis was confirmed by decreased end-tidal carbon dioxide, hypotension, and a mill wheel murmur.

Findings:

  • The patient experienced a nonfatal air embolism.
  • Supportive treatment led to full recovery without complications.
  • End-tidal carbon dioxide monitoring proved crucial for early detection.

Implications:

  • Highlights the risk of air embolism during shoulder arthroscopy for acute fractures.
  • Emphasizes the importance of vigilance and monitoring for this complication.
  • Suggests end-tidal carbon dioxide monitoring as a key diagnostic tool.