Severe cerebral injury secondary to an air embolism following ERCP for biliary calculus extraction: a case report

This report describes a rare case of severe cerebral injury secondary to an air embolism following endoscopic retrograde cholangiopancreatography (ERCP) with stone extraction. Through meticulous analysis of this complication, we aim to elucidate the potential mechanisms responsible for inadvertent gas entry during therapeutic procedures, evaluate strategies for early detection, and discuss precautionary measures to enhance procedural safety in biliary interventions. This study provides valuable insights into understanding and potentially reducing such adverse iatrogenic outcomes in interventional endoscopy practice.

This is a retrospective case study describing the full inpatient journey of one patient in the Department of Gastroenterology.

During the ERCP procedure, the patient experienced a decrease in oxygenation and a significant increase in blood pressure. The procedure was temporarily stopped to allow for stabilization of the patient's condition. Following recovery, the surgical procedure was resumed. However, the patient again experienced decreased oxygenation, accompanied by hypotension and bradycardia. Immediate resuscitation measures were initiated, followed by admission to the critical care medicine (CCM) unit. Despite these interventions, the patient developed severe cerebral injury. Ultimately, following the family's decision to withdraw treatment, the patient was discharged from the hospital.