Advancements in laparoscopic surgery have resulted in decreased length of hospitalization, reduced
postoperative pain, and better cosmesis following general surgical procedures. Carbon dioxide gas
embolism is a rare occurrence that can be fatal. We report the case of a patient with a venous gas
embolism during laparoscopic cholecystectomy.
A 63-year-old woman presented with intermittent right upper quadrant pain, and her abdominal
ultrasound showed a possible gallbladder polyp. A laparoscopic cholecystectomy was planned.
A Veress needle was placed in the right upper quadrant to initiate abdominal access. Shortly after
carbon dioxide insufflation, the patient's hemodynamic status deteriorated, her oxygen saturation
dropped, and her end-tidal CO2 decreased. Gas insufflation was immediately stopped, and the patient
was resuscitated. She stabilized quickly, and the procedure was performed without further
event. She did well postoperatively and was discharged home the next day.
Carbon dioxide embolism during laparoscopy, albeit rare, can be a fatal complication of the procedure.
Whenever sudden changes in hemodynamic stability occur, venous gas embolism should be
considered. As laparoscopic techniques and applications are expanded, the general surgeon must be
aware of this entity.
