Iatrogenic Venous Air Embolism (VAE) in a patient secondary to contrast injection; a rare case
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Abstract
Venous Air Embolism (VAE) can occur in patients while injecting contrast material, we have reported a case of a 26 yrs old patient who came with the complaint of abdominal pain, vomiting, and fever with no known Co-morbid. CT whole abdomen with contrast was performed and the patient was injected with contrast, which resulted in an air embolism. On administration of contrast, air is seen in the hepatic vein which was not seen on plain and delayed images. 93 ml of contrast material was intravenously injected by hand and followed by a drip infusion of 100 ml of contrast material.
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Sodhi KS, Das PJ, Malhotra P, Khandelwal N. Venous air embolism after intravenous contrast administration for computed tomography. J Emerg Med. 2012 Apr;42(4):450-1. doi: 10.1016/j.jemermed.2009.11.025. Epub 2010 Jan 25. PMID: 20097505.
Ie SR, Rozans MH, Szerlip HM. Air embolism after intravenous injection of contrast material. South Med J. 1999 Sep;92(9):930-3. doi: 10.1097/00007611-199909000-00019. PMID: 10498176.
Ie SR, Rozans MH, Szerlip HM. Air embolism after intravenous injection of contrast material. South Med J. 1999 Sep;92(9):930-3. doi: 10.1097/00007611-199909000-00019. PMID: 10498176.
Woodring JH, Fried AM. Nonfatal venous air embolism after contrast-enhanced CT. Radiology. 1988 May;167(2):405-7. doi: 10.1148/radiology.167.2.3357948. PMID: 3357948.
Rubinstein D, Symonds D. Gas in the cavernous sinus. AJNR Am J Neuroradiol. 1994 Mar;15(3):561-6. PMID: 8197958; PMCID: PMC8334314.
Orebaugh SL. Venous air embolism: clinical and experimental considerations. Crit Care Med. 1992 Aug;20(8):1169-77. doi: 10.1097/00003246-199208000-00017. PMID: 1643897.
O'Quin RJ, Lakshminarayan S. Venous air embolism. Arch Intern Med. 1982 Nov;142(12):2173-6. PMID: 7138162.
Goodwin J, Gnanapandithan K. Air embolism after peripheral IV contrast injection. Cleve Clin J Med. 2020 Nov 23;87(12):718-720. doi: 10.3949/ccjm.87a.20001. PMID: 33229386; PMCID: PMC8048767.
Rana BS, Thomas MR, Calvert PA, Monaghan MJ, Hildick-Smith D. Echocardiographic evaluation of patent foramen ovale prior to device closure. JACC Cardiovasc Imaging. 2010 Jul;3(7):749-60. doi: 10.1016/j.jcmg.2010.01.007. PMID: 20633854.
Schawkat K, Litmanovich D, Appel E, Ghorishi A, Selim M, Manning WJ, Nakhaei M, Biglione B, Camacho A, Brook OR. Embolic Events After Computed Tomography Contrast Injection in Patients With Interatrial Shunts: A Cohort Study. J Thorac Imaging. 2022 Sep 1;37(5):331-335. doi: 10.1097/RTI.0000000000000663. Epub 2022 Jun 23. PMID: 35797552.
Moser J, Sheard S, Patel J, Sayer C, Madden B, Vlahos I. Iatrogenic peripheral pulmonary air embolism following intravenous contrast administration for CT pulmonary angiography: proposal of the "double bronchus sign". BJR Case Rep. 2017 Feb 13;3(2):20160097. doi: 10.1259/bjrcr.20160097. PMID: 30363281; PMCID: PMC6159241.
Davies A, Mathur N, Lau T, Crossett M, Lau KK. Venous air embolism in CT coronary angiography. J Med Imaging Radiat Oncol. 2022 Apr;66(3):351-356. doi: 10.1111/1754-9485.13316. Epub 2021 Aug 20. PMID: 34415110.
Kearney KR, Smith MD, Xie GY, Gurley JC. Massive air embolus to the left ventricle: diagnosis and monitoring by serial echocardiography. J Am Soc Echocardiogr. 1997 Nov-Dec;10(9):982-7. doi: 10.1016/s0894-7317(97)80017-x. PMID: 9440078.
Jia X, Li X, Li J, Jin C, Chen J, Huang X, Wang Y, Guo J, Yang J. Reducing the incidence of venous air embolism in contrast-enhanced CT angiography using preflushing of the power injector. Clin Radiol. 2020 Jun;75(6):479.e1-479.e7. doi: 10.1016/j.crad.2019.12.025. Epub 2020 Feb 5. PMID: 32035624.
Czibur A, Ferchaw M, Vazquez D, Mikell S, Schwenke C, Endrikat J. Comparison of 2 CT Contrast Media Injection Systems: Visual Air Identification and Injector Face Cleaning. Radiol Technol. 2020 Jan;91(3):214-222. PMID: 32060078.
Cunningham G, Cameron G, De Cruz P. Hepatic portal venous gas in Crohn's disease. BMJ Case Rep. 2014 Sep 26;2014:bcr2014206244. doi: 10.1136/bcr-2014-206244. PMID: 25260428; PMCID: PMC4180553.