Delayed presentation of cerebellar and spinal cord infarction as a complication of computed tomography-guided transthoracic lung biopsy: A case report

被引：4

作者：

Shin K.M. ^{[1
]}

Lim J.-K. ^{[1
]}

Kim C.-H. ^{[2
]}

机构：

[1] Department of Radiology, Kyungpook National University, School of Medicine, 680 Gukchaebosang-ro, Jung-gu, Daegu

[2] Department of Internal Medicine, Kyungpook National University, School of Medicine, 680 Gukchaebosang-ro, Jung-gu, Daegu

来源：

Journal of Medical Case Reports | / 8卷 / 1期

关键词：

Air embolism; Complication; Lung biopsy;

D O I：

10.1186/1752-1947-8-272

中图分类号：

学科分类号：

摘要：

Introduction: Computed tomography-guided transthoracic needle biopsy is a common diagnostic procedure that is associated with various complications including pneumothorax, parenchymal hemorrhage, and hemoptysis. A systemic air embolism is a very rare (0.06 to 0.21%) but potentially fatal complication. Case presentation: A 70-year-old Korean male was admitted to our hospital for evaluation of a solitary pulmonary nodule located adjacent to the right inferior pulmonary vein in the medial basal segment of the right lower lobe. A computed tomography-guided needle biopsy was performed by a radiologist using a coaxial needle. A computed tomography image obtained immediately after the biopsy showed intraluminal free air in the proximal ascending aorta. He complained of a mild electrical current sensation in both lower extremities. After three hours he complained of neurological deficit in both lower extremities as well as voiding difficulty. The brain and spine magnetic resonance images showed a right cerebellar and spinal cord infarction at the T8-10 levels. Conclusions: We report a case of air embolism to the cerebellum and spinal cord causing infarction presenting with an initial symptom of mild electrical current sensation in both lower extremities during the transthoracic needle biopsy. For this potentially fatal complication, early recognition, followed by prompt therapy is critical to reducing morbidity and mortality. © 2014 Shin et al.; licensee BioMed Central Ltd.

引用

共 9 条

[1]

Sinner W.N., Complications of percutaneous transthoracic needle aspiration biopsy, Acta Radiol Diagn, 17, pp. 813-828, (1976)

[2]

Tomiyama N., Yasuhara Y., Nakajima Y., Adachi S., Arai Y., Kusumoto M., Eguchi K., Kuriyama K., Sakai F., Noguchi M., Murata K., Murayama S., Mochizuki T., Mori K., Yamada K., CT-guided needle biopsy of lung lesions: A survey of severe complication based on 9783 biopsies in Japan, Eur J Radiol, 59, pp. 60-64, (2006)

[3]

Ibukuro K., Tanaka R., Takeguchi T., Fukuda H., Abe S., Tobe K., Air embolism and needle track implantation complicating CT-guided percutaneous thoracic biopsy: Single-institution experience, Am J Roentgenol, 193, pp. W430-W436, (2009)

[4]

Mansour A., AbdelRaouf S., Qandeel M., Swaidan M., Acute coronary artery air embolism following CT-guided lung biopsy, Cardiovasc Intervent Radiol, 28, pp. 131-134, (2005)

[5]

Arnold B.W., Zwiebel W.J., Percutaneous transthoracic needle biopsy complicated by air embolism, Am J Roentgenol, 178, pp. 1400-1402, (2002)

[6]

Ashizawa K., Watanabe H., Morooka H., Hayashi K., Hyperbaric oxygen therapy for air embolism complicating CT-guided needle biopsy of the lung, Am J Roentgenol, 182, pp. 1606-1607, (2004)

[7]

MacLean C.A., Bachman D.T., Documented arterial gas embolism after spinal epidural injection, Ann Emerg Med, 38, pp. 592-595, (2001)

[8]

Blanc P., Boussuges A., Henriette K., Sainty J.M., Deleflie M., Iatrogenic cerebral air embolism: Importance of an early hyperbaric oxygenation, Intensive Care Med, 28, pp. 559-563, (2002)

[9]

Hiraki T., Fujiwara H., Sakurai J., Iguchi T., Gobara H., Tajiri N., Mimura H., Kanazawa S., Nonfatal systemic air embolism complicating percutaneous CT-guided transthoracic needle biopsy: Four cases from a single institution, Chest, 132, pp. 684-690, (2007)

← 1 →