Vascular air embolism (VAE) can be a lethal complication of surgical approaches, and it has been documented in various urologic procedures. A case of VAE complicating a percutaneous nephrolithotomy in a 47-year-old man is presented, well documented by immunohistochemical examination of lung samples and three-dimensional imaging of histologic sections with confocal laser scanning microscopy. Vascular air embolism (VAE), the entry of gas into the vascular structures, is a mainly iatrogenic clinical problem that can result in serious morbidity and even in death. Although this complication has been documented in various urologic procedures,1; 2; 3; 4 ;  5 its occurrence after percutaneous nephrolithotomy (PCNL) has been reported in few cases.6 ;  7 To the best of our knowledge only 1 fatal case of VAE complicating PCNL has been described to date. The cause of death was established only on the basis of the macroscopic finding of the right femoral venous system being filled with air and very abundant segmented air in the meningeal venous structure.8 We present a fatal case of VAE complicating PCNL, in which the cause of death was established on the basis of microscopic findings after autopsical examination.

Vascular air embolism complicating percutaneous nephrolithotomy: medical malpractice or fatal unforeseeable complication?

NERI, Margherita;
2009

Abstract

Vascular air embolism (VAE) can be a lethal complication of surgical approaches, and it has been documented in various urologic procedures. A case of VAE complicating a percutaneous nephrolithotomy in a 47-year-old man is presented, well documented by immunohistochemical examination of lung samples and three-dimensional imaging of histologic sections with confocal laser scanning microscopy. Vascular air embolism (VAE), the entry of gas into the vascular structures, is a mainly iatrogenic clinical problem that can result in serious morbidity and even in death. Although this complication has been documented in various urologic procedures,1; 2; 3; 4 ;  5 its occurrence after percutaneous nephrolithotomy (PCNL) has been reported in few cases.6 ;  7 To the best of our knowledge only 1 fatal case of VAE complicating PCNL has been described to date. The cause of death was established only on the basis of the macroscopic finding of the right femoral venous system being filled with air and very abundant segmented air in the meningeal venous structure.8 We present a fatal case of VAE complicating PCNL, in which the cause of death was established on the basis of microscopic findings after autopsical examination.
2009
Turillazzi, E; Pomara, C; Bisceglia, R; Neri, Margherita; Riezzo, I; Pomara, G; Francesca, F; Fineschi, V.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11392/2357105
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