Successful management of a large air embolus during an extended right hepatectomy with an emergency cardiopulmonary bypass

Abstract

Background An air embolus is a recognized but rare complication of a partial hepatectomy. The aim of this report was to describe the diagnosis and management of a large paradoxical air embolus during hepatic resection. Methods Case report. Results A single patient report of a massive paradoxical air embolus during an extended right hepatectomy is described. The diagnosis was confirmed by trans-oesophageal echo (video provided). After failed conservative management an emergency cardiopulmonary bypass was instituted with a successful outcome. Conclusion Surgeons and anaesthetists involved in hepatic surgery should be aware of signs, investigations and management of this life-threatening intra-operative complication. © 2012 International Hepato-Pancreato- Biliary Association.