Transient venous air embolism after ERCP: worrisome or not?

Theodor Alexandru Voiosu1,2, Andrada Viorela Gheorghe1, Gabriel Lepădat3, Radu Bogdan Mateescu1,2, Mihai Rimbaș1,2

Affiliation and address for correspondence
J Ultrason 2020; 20: e67–e69
DOI: 10.15557/JoU.2020.0011

The paper describes the occurrence of a rare complication – portal and systemic venous air embolism – after endoscopic retrograde cholangiopancreatography, related to the endoscopic procedure. It can be associated with the more frequently encountered post-endoscopic retrograde cholangiopancreatography complications pancreatitis or cholangitis. However, it can also be noted with perforation. The presented case suggests that in the clinical context an early abdominal ultrasound examination confirming hepatic portal venous gas and/or systemic venous air embolism could be useful for the diagnosis of post-endoscopic retrograde cholangiopancreatography retroduodenal perforation, and thus highlights the need for a high index of suspicion should this occurrence be noted post-procedurally, in order to ensure the best care of patients.

intrahepatic portal venous gas; venous embolism; ERCP; retroduodenal perforation; retropneumoperitoneum