SHM Converge Scientific Abstract ePoster Gallery-Venous Air Embolism as Late Complication of Upper Endoscopy, Exacerbated by Campylobacter Infection

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This case report describes a 69-year-old man with prior laparoscopic sleeve gastrectomy who presented to the ED with 3 days of watery nonbloody diarrhea, vomiting, and high fevers. Two months earlier, he had undergone an outpatient EGD with duodenal polyp resection and immediately developed subcutaneous emphysema involving the face, neck, and chest, along with pneumomediastinum and a left pneumothorax, which resolved with conservative treatment.<br /><br />On the current admission, he was tachycardic and mildly hypoxic but appeared clinically well. CT imaging showed a small gas embolus in the proximal main pulmonary artery, consistent with venous air embolism, and CT abdomen/pelvis showed acute colitis without bowel perforation or portal venous gas. A stool GI pathogen panel was positive for Campylobacter spp.<br /><br />He was treated supportively for the air embolism with high-flow supplemental oxygen, left lateral decubitus positioning, and IV fluids; echocardiogram was normal, and he weaned off oxygen by hospital day 2. He was initially started on ceftriaxone and metronidazole, then switched to azithromycin after Campylobacter was identified. His diarrhea and fevers improved, and he was discharged home on hospital day 4.<br /><br />The authors propose that the prior EGD caused mucosal injury or a weak point in the GI tract, and that acute Campylobacter colitis may have worsened this defect, allowing air to enter the venous system. While the connection cannot be proven definitively, the case highlights that venous air embolism is a rare but serious complication of endoscopy and may present later than the procedure itself.

Asset Subtitle

Eric Chu

Meta Tag

Author List Eric Chu

Category Clinical Vignettes

Concept Pulmonary Artery Air Embolism

Concept Oxygen Therapy

Concept Endoscopic Procedure

Concept Clinical Presentation

Concept Imaging Finding

Distinguished Non-Finalist

Presenter Organization Duke Raleigh Hospital

Presenting Author Eric Chu

Track Adult

Keywords

venous air embolism

endoscopy complication

Campylobacter colitis

gastrointestinal bleeding

pneumomediastinum

pulmonary artery gas embolus

duodenal polyp resection

laparoscopic sleeve gastrectomy

high-flow oxygen therapy

acute diarrhea

Pulmonary Artery Air Embolism

Oxygen Therapy

Endoscopic Procedure

Clinical Presentation

Imaging Finding