Fatal Air Embolism in Therapeutic Pneumoperitoneum

Abstract

Introduction of air into the peritoneal cavity by means of needle puncture is an old procedure. It has been used for local treatment of tubercubous peritonitis as early as 1893, as a diagnostic procedure since 1902 and for the treatment of pulmonary tuberculosis since 1933. The safety and simplicity of pneumoperitoneum have made it a widely utilized procedure in the treatment of pulmonary tuberculosis, however, ill effects from pneumoperitoneum have been witnessed. Among the complications to be considered are perforation of an abdominal viscus, pentoneal effusion and air embolism. With the increasing use of pneumoperitoneum, air embolism, the most serious of these complications, has occurred more frequently as indicated by recent reports.11’ Of 127 cases of air embolism reported in the medical literature, 74 have been fatal. The incidence of air embolism during pneumoperitoneum therapy is probably higher than indicated by these reports. The purpose of this paper is to report in detail one fatal case of air embolism which was observed at the Ohio Tuberculosis Hospital. During preparation of this report, six additional unreported cases were cited by personal communications from reputable sources.’31’ These six additional cases were also fatal, but details of these are not complete enough to warrant extensive presentation.