Multiorgan air embolism as a complication of ruptured gastric ulcer

Abstract

Introduction: The gas in the vessels of the portal system and arterial vessels is a very disturbing symptom and life-threatening condition. Aim: The aim of this study is to present a case of gas in the left ventricle (LV), ascending aorta (Ao), superior mesenteric vein (SMV) and hepatic portal vein (HPV) as a complication of gastric ulcer perforation (GUP). Case study: A 78-year-old male patient, who had undergone a laparotomy due to gas in the HPV, SMV, Ao, and both chambers of the heart with concomitant GUP and critical pyloric stenosis. Laparotomy revealed perforation of the gastric wall with limited wall necrosis and critical pyloric stenosis. The patient died on postoperative day 1 due to multiple organ failure. Results and discussion: The presence of gas in HPV (HPVG) and systemic circulation is a rare pathological condition associated with various abdominal diseases. GUP with a gas in the HPV, MV and Ao is very rare. While the mechanism of gas entry into the portal veins of the portal system is better understood, the paths of gas entry into the arterial vessels are still not fully understood and their descriptions are casuistic. Conclusions: The treatment of patients with air in the HPV and systemic vessels is extremely difficult and has a very high risk of failure.