[Fatal carbon dioxide embolism as a complication of endoscopic interventions]

Fatal complications during laparoscopy mostly originate from injury to major pelvic vessels, causing severe hemorrhage or carbon dioxide embolism. We report a case of a 30-year-old patient who--after unsuccessful resuscitation--died during gynecologic laparoscopy. The noted signs corresponded to acute gas embolism, particularly as ultrasound revealed intravascular gas pulsation. At autopsy, 2 days post mortem, a puncture of the left common iliac vein was discovered. Despite this, gas bubbles in the right heart could not be confirmed. Pre-conditions for fatal carbon dioxide embolism are stressed. To prove the presence of carbon dioxide gas post mortem, autopsy has to be performed as soon as possible and the corpse has to be stored without cooling.